- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,816.95 / $7,902.81 / $12,443.50
| Facility | | $5,816.95 | $7,902.81 | $12,443.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,734.71 / $7,377.06 / $11,884.33
| Facility | | $4,734.71 | $7,377.06 | $11,884.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,074.54 / $7,117.92 / $12,680.00
| Facility | | $5,074.54 | $7,117.92 | $12,680.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53.05 / $78.66 / $125.00
| Facility | | $53.05 | $78.66 | $125.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,589.34 / $7,735.43 / $12,730.72
| Facility | | $5,589.34 | $7,735.43 | $12,730.72 |