- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,125.00 / $17,177.90 / $23,763.60
| Facility | | $5,125.00 | $17,177.90 | $23,763.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,050.38
| Facility | | $1,146.00 | $3,000.00 | $6,050.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,465.53 / $8,933.39 / $16,570.15
| Facility | | $6,465.53 | $8,933.39 | $16,570.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,465.53 / $9,225.00 / $16,570.15
| Facility | | $6,465.53 | $9,225.00 | $16,570.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,817.50 / $11,433.88 / $17,728.40
| Facility | | $4,817.50 | $11,433.88 | $17,728.40 |