- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,005.00 / $10,563.53 / $20,928.72
| Facility | | $5,005.00 | $10,563.53 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,065.60 / $6,609.33 / $12,887.71
| Facility | | $5,065.60 | $6,609.33 | $12,887.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,942.51 / $3,942.51 / $3,942.51
| Facility | | $3,942.51 | $3,942.51 | $3,942.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $626.04 / $1,383.98 / $8,595.76
| Facility | | $626.04 | $1,383.98 | $8,595.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,079.56 / $1,739.44 / $5,041.80
| Facility | | $1,079.56 | $1,739.44 | $5,041.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |