- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,441.70 / $8,136.11 / $11,519.90
| Facility | | $4,441.70 | $8,136.11 | $11,519.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,065.35 / $9,065.35 / $9,065.35
| Facility | | $9,065.35 | $9,065.35 | $9,065.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,718.32 / $7,652.34 / $12,307.55
| Facility | | $4,718.32 | $7,652.34 | $12,307.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,618.02 / $7,318.86 / $13,021.42
| Facility | | $4,618.02 | $7,318.86 | $13,021.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,428.53 / $7,099.86 / $15,397.85
| Facility | | $3,428.53 | $7,099.86 | $15,397.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,000.00 / $7,134.84 / $13,683.33
| Facility | | $3,000.00 | $7,134.84 | $13,683.33 |