- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81.28 / $3,235.94 / $7,943.28
| Facility | | $81.28 | $3,235.94 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $7,079.46 / $16,595.87
| Facility | | $2,137.96 | $7,079.46 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,238.72 / $5,370.32
| Facility | | $1,584.89 | $2,238.72 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $2,137.96 / $4,168.69
| Facility | | $1,737.80 | $2,137.96 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,548.82 / $5,495.41
| Facility | | $691.83 | $1,548.82 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $6,760.83 / $10,715.19
| Facility | | $1,584.89 | $6,760.83 | $10,715.19 |