- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,782.06 / $3,782.06 / $3,782.06
| Facility | | $3,782.06 | $3,782.06 | $3,782.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,142.55 / $10,743.99 / $32,431.67
| Facility | | $4,142.55 | $10,743.99 | $32,431.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,302.81 / $13,192.53 / $31,736.43
| Facility | | $9,302.81 | $13,192.53 | $31,736.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,562.51 / $12,061.14 / $24,989.31
| Facility | | $7,562.51 | $12,061.14 | $24,989.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,500.00 / $6,391.68 / $9,780.00
| Facility | | $3,500.00 | $6,391.68 | $9,780.00 |
- 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 |