- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,142.50 / $10,533.00 / $14,571.10
| Facility | | $3,142.50 | $10,533.00 | $14,571.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $2,965.55 / $4,514.93
| Facility | | $1,146.00 | $2,965.55 | $4,514.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,964.47 / $5,477.69 / $10,160.33
| Facility | | $3,964.47 | $5,477.69 | $10,160.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,964.47 / $5,656.50 / $10,160.33
| Facility | | $3,964.47 | $5,656.50 | $10,160.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,036.00 / $7,010.92 / $10,870.54
| Facility | | $3,036.00 | $7,010.92 | $10,870.54 |