- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,475.20 / $9,173.20 / $15,434.70
| Facility | | $6,475.20 | $9,173.20 | $15,434.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,812.31 / $10,812.31 / $10,812.31
| Facility | | $10,812.31 | $10,812.31 | $10,812.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,790.00 / $3,447.00 / $8,976.11
| Facility | | $1,790.00 | $3,447.00 | $8,976.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,958.68 / $10,554.58 / $17,699.96
| Facility | | $6,958.68 | $10,554.58 | $17,699.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.00 / $4,829.00 / $16,319.66
| Facility | | $1,778.00 | $4,829.00 | $16,319.66 |