- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,511.89 / $9,772.37
| Facility | | $1,000.00 | $2,511.89 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $3,981.07 / $19,054.61
| Facility | | $2,951.21 | $3,981.07 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $11,481.54 / $13,489.63
| Facility | | $8,317.64 | $11,481.54 | $13,489.63 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $724.44 / $1,348.96 / $3,388.44
| Professional | | $724.44 | $1,348.96 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $4,365.16 / $8,128.31
| Facility | | $1,584.89 | $4,365.16 | $8,128.31 |