- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,584.00 / $18,716.40 / $25,891.90
| Facility | | $5,584.00 | $18,716.40 | $25,891.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,955.52
| Facility | | $1,146.00 | $3,000.00 | $5,955.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,044.58 / $9,733.46 / $18,054.18
| Facility | | $7,044.58 | $9,733.46 | $18,054.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,044.58 / $10,051.20 / $18,054.18
| Facility | | $7,044.58 | $10,051.20 | $18,054.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.96 / $10,875.40 / $19,316.16
| Facility | | $5,248.96 | $10,875.40 | $19,316.16 |