- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $879.14 / $1,260.22 / $7,762.52
| Facility | | $879.14 | $1,260.22 | $7,762.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $752.51 / $822.90 / $896.56
| Facility | | $752.51 | $822.90 | $896.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $835.49 / $835.49 / $835.49
| Facility | | $835.49 | $835.49 | $835.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $861.60 / $1,546.83 / $4,109.93
| Facility | | $861.60 | $1,546.83 | $4,109.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,910.00 / $2,910.00 / $2,910.00
| Facility | | $2,910.00 | $2,910.00 | $2,910.00 |