- 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
- $3,007.90 / $3,924.55 / $7,652.58
| Facility | | $3,007.90 | $3,924.55 | $7,652.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,141.50 / $3,141.50 / $3,141.50
| Facility | | $3,141.50 | $3,141.50 | $3,141.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $782.08 / $1,666.44 / $8,816.00
| Facility | | $782.08 | $1,666.44 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,285.00 / $2,172.94 / $4,133.42
| Facility | | $1,285.00 | $2,172.94 | $4,133.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |