- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,275.50 / $7,626.98 / $10,551.00
| Facility | | $2,275.50 | $7,626.98 | $10,551.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $8,270.28
| Facility | | $1,146.00 | $3,000.00 | $8,270.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,870.69 / $3,966.42 / $7,357.15
| Facility | | $2,870.69 | $3,966.42 | $7,357.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,870.69 / $4,095.90 / $7,357.15
| Facility | | $2,870.69 | $4,095.90 | $7,357.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,036.00 / $5,144.91 / $7,871.41
| Facility | | $3,036.00 | $5,144.91 | $7,871.41 |