- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $7,943.28 / $10,471.29
| Facility | | $3,090.30 | $7,943.28 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $10,471.29 / $10,471.29
| Facility | | $10,471.29 | $10,471.29 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $9,120.11 / $10,232.93
| Facility | | $6,606.93 | $9,120.11 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $8,317.64 / $11,481.54
| Facility | | $6,760.83 | $8,317.64 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $6,025.60 / $10,232.93
| Facility | | $1,819.70 | $6,025.60 | $10,232.93 |