- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,107.00 / $10,414.00 / $14,406.50
| Facility | | $3,107.00 | $10,414.00 | $14,406.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,694.19
| Facility | | $1,146.00 | $3,000.00 | $5,694.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,919.69 / $5,415.81 / $10,045.54
| Facility | | $3,919.69 | $5,415.81 | $10,045.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,919.69 / $5,592.60 / $10,045.54
| Facility | | $3,919.69 | $5,592.60 | $10,045.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,036.00 / $6,931.72 / $10,747.73
| Facility | | $3,036.00 | $6,931.72 | $10,747.73 |