- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,494.35 / $1,494.35 / $9,768.00
| Facility | | $1,494.35 | $1,494.35 | $9,768.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,647.11 / $6,778.24 / $13,299.12
| Facility | | $2,647.11 | $6,778.24 | $13,299.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,777.55 / $5,357.04 / $12,887.09
| Facility | | $3,777.55 | $5,357.04 | $12,887.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,070.88 / $4,897.62 / $10,147.31
| Facility | | $3,070.88 | $4,897.62 | $10,147.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,033.95 / $2,715.13 / $3,909.71
| Facility | | $2,033.95 | $2,715.13 | $3,909.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.00 / $3,500.00 / $8,152.00
| Facility | | $1,751.00 | $3,500.00 | $8,152.00 |