- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $3,630.78 / $7,943.28
| Facility | | $912.01 | $3,630.78 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $8,511.38 / $8,912.51
| Facility | | $4,168.69 | $8,511.38 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $446.68 / $446.68
| Facility | | $446.68 | $446.68 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $933.25 / $8,317.64
| Facility | | $575.44 | $933.25 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $4,265.80 / $6,309.57
| Facility | | $1,862.09 | $4,265.80 | $6,309.57 |