- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,931.83 / $1,931.83 / $1,931.83
| Facility | | $1,931.83 | $1,931.83 | $1,931.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,706.66 / $7,969.32 / $15,836.50
| Facility | | $3,706.66 | $7,969.32 | $15,836.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,281.22 / $6,071.31 / $14,605.37
| Facility | | $4,281.22 | $6,071.31 | $14,605.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,480.33 / $5,550.64 / $11,500.29
| Facility | | $3,480.33 | $5,550.64 | $11,500.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,903.80 / $3,264.79 / $4,794.04
| Facility | | $1,903.80 | $3,264.79 | $4,794.04 |
- 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 |