- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $948.33 / $1,470.54 / $5,135.56
| Facility | | $948.33 | $1,470.54 | $5,135.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,018.68 / $1,138.83 / $1,240.77
| Facility | | $1,018.68 | $1,138.83 | $1,240.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,085.08 / $1,085.08 / $1,085.08
| Facility | | $1,085.08 | $1,085.08 | $1,085.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,287.65 / $12,287.65 / $12,287.65
| Facility | | $12,287.65 | $12,287.65 | $12,287.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,439.00 / $4,439.00 / $4,439.00
| Facility | | $4,439.00 | $4,439.00 | $4,439.00 |