- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $870.96 / $7,762.47
| Facility | | $870.96 | $870.96 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $7,585.78 / $20,892.96
| Facility | | $4,365.16 | $7,585.78 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $3,467.37 / $8,128.31
| Facility | | $2,398.83 | $3,467.37 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $3,311.31 / $6,456.54
| Facility | | $2,630.27 | $3,311.31 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,905.46 / $9,332.54
| Facility | | $1,202.26 | $1,905.46 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $6,025.60 / $10,000.00
| Facility | | $1,584.89 | $6,025.60 | $10,000.00 |