- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,904.41 / $6,321.12 / $12,846.20
| Facility | | $4,904.41 | $6,321.12 | $12,846.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,482.61 / $5,482.61 / $7,508.33
| Facility | | $5,482.61 | $5,482.61 | $7,508.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,881.25 / $6,118.75 / $6,995.31
| Facility | | $4,881.25 | $6,118.75 | $6,995.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,914.77 / $6,929.55 / $9,012.18
| Facility | | $3,914.77 | $6,929.55 | $9,012.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,305.00 / $8,634.58 / $9,020.83
| Facility | | $6,305.00 | $8,634.58 | $9,020.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $5,557.33 / $8,558.42
| Facility | | $1,286.00 | $5,557.33 | $8,558.42 |