- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $3,162.28 / $8,511.38
| Facility | | $870.96 | $3,162.28 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $1,819.70 / $1,819.70
| Facility | | $1,737.80 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $12,589.25 / $12,589.25
| Facility | | $12,589.25 | $12,589.25 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $1,819.70 / $12,022.64
| Facility | | $616.60 | $1,819.70 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,951.21 / $6,309.57
| Facility | | $1,862.09 | $2,951.21 | $6,309.57 |