- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,564.12 / $7,655.00 / $13,151.00
| Facility | | $2,564.12 | $7,655.00 | $13,151.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,594.00 / $4,862.07 / $9,893.29
| Facility | | $3,594.00 | $4,862.07 | $9,893.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $914.00 / $914.00 / $914.00
| Facility | | $914.00 | $914.00 | $914.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,087.00 / $1,907.15 / $3,206.56
| Facility | | $1,087.00 | $1,907.15 | $3,206.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $783.00 / $1,743.00 / $5,562.00
| Facility | | $783.00 | $1,743.00 | $5,562.00 |