- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,055.96 / $5,227.58 / $10,623.80
| Facility | | $4,055.96 | $5,227.58 | $10,623.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,551.50 / $4,551.50 / $4,551.50
| Facility | | $4,551.50 | $4,551.50 | $4,551.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,986.65 / $4,997.35 / $5,713.26
| Facility | | $3,986.65 | $4,997.35 | $5,713.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,237.52 / $5,730.75 / $7,453.09
| Facility | | $3,237.52 | $5,730.75 | $7,453.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,234.22 / $5,234.22 / $5,234.22
| Facility | | $5,234.22 | $5,234.22 | $5,234.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $4,595.92 / $7,077.83
| Facility | | $1,286.00 | $4,595.92 | $7,077.83 |