- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $7,943.28 / $14,454.40
| Facility | | $6,025.60 | $7,943.28 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $5,128.61 / $10,000.00
| Facility | | $3,890.45 | $5,128.61 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $1,023.29 / $5,495.41
| Facility | | $489.78 | $1,023.29 | $5,495.41 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,122.02 / $1,548.82
| Professional | | $1,071.52 | $1,122.02 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,754.23 / $6,309.57
| Facility | | $1,548.82 | $2,754.23 | $6,309.57 |