- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $866.94 / $866.94 / $866.94
| Facility | | $866.94 | $866.94 | $866.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.89 / $1,878.85 / $3,540.98
| Facility | | $1,550.89 | $1,878.85 | $3,540.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,928.78 / $2,735.26 / $6,580.03
| Facility | | $1,928.78 | $2,735.26 | $6,580.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,567.96 / $2,500.67 / $5,181.13
| Facility | | $1,567.96 | $2,500.67 | $5,181.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,242.89 / $1,712.45 / $3,500.00
| Facility | | $1,242.89 | $1,712.45 | $3,500.00 |
- 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 |