- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,591.71 / $3,591.71 / $3,591.71
| Facility | | $3,591.71 | $3,591.71 | $3,591.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,942.11 / $14,925.53 / $30,079.63
| Facility | | $6,942.11 | $14,925.53 | $30,079.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,946.76 / $11,269.49 / $27,110.29
| Facility | | $7,946.76 | $11,269.49 | $27,110.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,460.14 / $10,303.02 / $21,346.69
| Facility | | $6,460.14 | $10,303.02 | $21,346.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,312.03 / $5,686.84 / $8,881.40
| Facility | | $3,312.03 | $5,686.84 | $8,881.40 |
- 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 |