- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,641.65 / $7,784.58 / $13,028.60
| Facility | | $5,641.65 | $7,784.58 | $13,028.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,893.65 / $9,893.65 / $13,069.65
| Facility | | $9,893.65 | $9,893.65 | $13,069.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $8,811.87 / $13,571.73
| Facility | | $2,423.00 | $8,811.87 | $13,571.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,774.18 / $8,757.99 / $14,687.10
| Facility | | $5,774.18 | $8,757.99 | $14,687.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $7,068.18 / $15,716.92
| Facility | | $2,600.00 | $7,068.18 | $15,716.92 |