- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,408.34 / $1,408.34 / $1,408.34
| Facility | | $1,408.34 | $1,408.34 | $1,408.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,700.48 / $5,806.03 / $11,454.00
| Facility | | $2,700.48 | $5,806.03 | $11,454.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,134.06 / $4,444.49 / $10,691.83
| Facility | | $3,134.06 | $4,444.49 | $10,691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,547.77 / $4,063.33 / $8,418.76
| Facility | | $2,547.77 | $4,063.33 | $8,418.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,848.17 / $2,602.51 / $3,873.50
| Facility | | $1,848.17 | $2,602.51 | $3,873.50 |
- 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 |