- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,415.04 / $6,092.05 / $10,195.90
| Facility | | $4,415.04 | $6,092.05 | $10,195.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $7,070.42 / $10,660.42
| Facility | | $2,423.00 | $7,070.42 | $10,660.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $509.60 / $509.60 / $509.60
| Facility | | $509.60 | $509.60 | $509.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,518.76 / $6,853.82 / $11,493.82
| Facility | | $4,518.76 | $6,853.82 | $11,493.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $5,531.41 / $12,299.74
| Facility | | $2,600.00 | $5,531.41 | $12,299.74 |