- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,044.60 / $5,580.91 / $9,340.45
| Facility | | $4,044.60 | $5,580.91 | $9,340.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,054.03 / $6,054.03 / $6,054.03
| Facility | | $6,054.03 | $6,054.03 | $6,054.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $6,500.48 / $9,828.37
| Facility | | $2,423.00 | $6,500.48 | $9,828.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,139.62 / $6,278.76 / $10,529.44
| Facility | | $4,139.62 | $6,278.76 | $10,529.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $5,067.31 / $11,267.74
| Facility | | $2,600.00 | $5,067.31 | $11,267.74 |