- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,563.83 / $1,563.83 / $1,563.83
| Facility | | $1,563.83 | $1,563.83 | $1,563.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,116.49 / $6,875.78 / $13,476.91
| Facility | | $3,116.49 | $6,875.78 | $13,476.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,641.95 / $5,164.74 / $12,424.47
| Facility | | $3,641.95 | $5,164.74 | $12,424.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,960.64 / $4,721.81 / $9,783.04
| Facility | | $2,960.64 | $4,721.81 | $9,783.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,040.73 / $2,642.87 / $3,952.95
| Facility | | $2,040.73 | $2,642.87 | $3,952.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,751.00 / $3,500.00 / $8,152.00
| Facility | | $1,751.00 | $3,500.00 | $8,152.00 |