- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,490.18 / $1,490.18 / $1,490.18
| Facility | | $1,490.18 | $1,490.18 | $1,490.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,859.52 / $6,147.96 / $12,152.00
| Facility | | $2,859.52 | $6,147.96 | $12,152.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,302.52 / $4,683.38 / $11,266.50
| Facility | | $3,302.52 | $4,683.38 | $11,266.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,684.71 / $4,281.72 / $8,871.26
| Facility | | $2,684.71 | $4,281.72 | $8,871.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,894.95 / $2,538.73 / $3,954.00
| Facility | | $1,894.95 | $2,538.73 | $3,954.00 |
- 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 |