- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,855.81 / $8,000.32 / $10,731.70
| Facility | | $3,855.81 | $8,000.32 | $10,731.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,153.89 / $6,153.89 / $6,153.89
| Facility | | $6,153.89 | $6,153.89 | $6,153.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $5,618.08 / $6,680.15
| Facility | | $2,651.00 | $5,618.08 | $6,680.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,800.27 / $8,261.20 / $13,002.88
| Facility | | $6,800.27 | $8,261.20 | $13,002.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $10,206.50
| Facility | | $1,350.00 | $5,713.00 | $10,206.50 |