- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,216.73 / $1,216.73 / $8,450.00
| Facility | | $1,216.73 | $1,216.73 | $8,450.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,550.32 / $8,221.73 / $18,574.04
| Facility | | $2,550.32 | $8,221.73 | $18,574.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,822.66 / $4,004.94 / $9,634.43
| Facility | | $2,822.66 | $4,004.94 | $9,634.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,295.80 / $3,661.48 / $7,586.16
| Facility | | $2,295.80 | $3,661.48 | $7,586.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,240.24 / $2,118.01 / $9,793.00
| Facility | | $1,240.24 | $2,118.01 | $9,793.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,940.00 / $8,689.00 / $11,531.00
| Facility | | $3,940.00 | $8,689.00 | $11,531.00 |