- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,247.00 / $2,629.57 / $5,538.66
| Facility | | $1,247.00 | $2,629.57 | $5,538.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,306.75 / $2,713.46 / $8,469.73
| Facility | | $1,306.75 | $2,713.46 | $8,469.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,926.60 / $4,276.55 / $8,278.96
| Facility | | $1,926.60 | $4,276.55 | $8,278.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,267.73 / $3,045.95 / $5,631.96
| Facility | | $2,267.73 | $3,045.95 | $5,631.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.00 / $1,543.00 / $4,395.60
| Facility | | $675.00 | $1,543.00 | $4,395.60 |