- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,449.96 / $2,449.96 / $2,449.96
| Facility | | $2,449.96 | $2,449.96 | $2,449.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,698.39 / $10,101.54 / $19,966.52
| Facility | | $4,698.39 | $10,101.54 | $19,966.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,417.44 / $7,682.61 / $18,481.55
| Facility | | $5,417.44 | $7,682.61 | $18,481.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,403.99 / $7,023.74 / $14,552.40
| Facility | | $4,403.99 | $7,023.74 | $14,552.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,032.62 / $3,954.00 / $6,692.67
| Facility | | $3,032.62 | $3,954.00 | $6,692.67 |
- 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 |