- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $4,897.79 / $11,220.18
| Facility | | $870.96 | $4,897.79 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $13,803.84 / $19,054.61
| Facility | | $3,715.35 | $13,803.84 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $575.44 / $645.65
| Facility | | $512.86 | $575.44 | $645.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $912.01 / $1,318.26
| Facility | | $602.56 | $912.01 | $1,318.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $6,025.60 / $10,715.19
| Facility | | $2,691.53 | $6,025.60 | $10,715.19 |