- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.07 / $641.07 / $641.07
| Facility | | $641.07 | $641.07 | $641.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.76 / $3,831.75 / $6,499.58
| Facility | | $2,088.76 | $3,831.75 | $6,499.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.97 / $2,197.76 / $5,287.01
| Facility | | $1,548.97 | $2,197.76 | $5,287.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,408.15 / $2,009.28 / $4,163.00
| Facility | | $1,408.15 | $2,009.28 | $4,163.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.29 / $1,109.68 / $1,932.03
| Facility | | $699.29 | $1,109.68 | $1,932.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,028.00 / $11,496.00 / $21,528.00
| Facility | | $5,028.00 | $11,496.00 | $21,528.00 |