- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,414.96 / $2,414.96 / $2,414.96
| Facility | | $2,414.96 | $2,414.96 | $2,414.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,184.29 / $10,376.14 / $18,919.45
| Facility | | $4,184.29 | $10,376.14 | $18,919.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,927.01 / $8,405.24 / $20,219.93
| Facility | | $5,927.01 | $8,405.24 | $20,219.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,818.22 / $7,684.40 / $15,921.21
| Facility | | $4,818.22 | $7,684.40 | $15,921.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,023.66 / $4,081.28 / $5,710.33
| Facility | | $3,023.66 | $4,081.28 | $5,710.33 |
- 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 |