- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,561.00 / $9,237.69 / $18,777.50
| Facility | | $1,561.00 | $9,237.69 | $18,777.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,655.24 / $2,655.24 / $3,304.00
| Facility | | $2,655.24 | $2,655.24 | $3,304.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,070.89 / $8,863.51 / $10,133.28
| Facility | | $7,070.89 | $8,863.51 | $10,133.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,672.27 / $10,129.04 / $13,173.27
| Facility | | $5,672.27 | $10,129.04 | $13,173.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,799.60 / $3,799.60 / $3,799.60
| Facility | | $3,799.60 | $3,799.60 | $3,799.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $3,800.00 / $11,417.57
| Facility | | $1,286.00 | $3,800.00 | $11,417.57 |