- 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
- $7,593.13 / $9,907.12 / $19,318.16
| Facility | | $7,593.13 | $9,907.12 | $19,318.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.89 / $535.83 / $2,304.75
| Facility | | $176.89 | $535.83 | $2,304.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.83 / $486.57 / $765.84
| Facility | | $267.83 | $486.57 | $765.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |