- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,244.02 / $2,244.02 / $2,244.02
| Facility | | $2,244.02 | $2,244.02 | $2,244.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,334.57 / $10,935.08 / $19,166.29
| Facility | | $5,334.57 | $10,935.08 | $19,166.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,158.63 / $8,733.70 / $21,010.12
| Facility | | $6,158.63 | $8,733.70 | $21,010.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,006.53 / $7,984.70 / $16,543.40
| Facility | | $5,006.53 | $7,984.70 | $16,543.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,295.00 / $3,814.85 / $5,664.67
| Facility | | $2,295.00 | $3,814.85 | $5,664.67 |
- 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 |