- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,166.76 / $2,791.82 / $12,929.35
| Facility | | $1,166.76 | $2,791.82 | $12,929.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,775.61 / $17,550.78 / $36,581.76
| Facility | | $5,775.61 | $17,550.78 | $36,581.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,954.66 / $4,190.08 / $10,079.79
| Facility | | $2,954.66 | $4,190.08 | $10,079.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,401.92 / $3,830.74 / $7,936.85
| Facility | | $2,401.92 | $3,830.74 | $7,936.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,697.40 / $2,456.81 / $12,051.00
| Facility | | $1,697.40 | $2,456.81 | $12,051.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |