- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,804.00 / $5,547.50 / $9,005.34
| Facility | | $3,804.00 | $5,547.50 | $9,005.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,693.09 / $10,936.88 / $14,021.64
| Facility | | $7,693.09 | $10,936.88 | $14,021.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.79 / $8,636.12 / $10,923.13
| Facility | | $4,466.79 | $8,636.12 | $10,923.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,968.84 / $5,965.94 / $9,539.79
| Facility | | $3,968.84 | $5,965.94 | $9,539.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,641.51 / $7,937.05 / $12,058.68
| Facility | | $4,641.51 | $7,937.05 | $12,058.68 |