- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $824.36 / $824.36 / $824.36
| Facility | | $824.36 | $824.36 | $824.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,190.72 / $16,192.78 / $36,581.76
| Facility | | $4,190.72 | $16,192.78 | $36,581.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,051.76 / $2,909.64 / $6,999.54
| Facility | | $2,051.76 | $2,909.64 | $6,999.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,667.93 / $2,660.11 / $5,511.45
| Facility | | $1,667.93 | $2,660.11 | $5,511.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,153.24 / $1,471.38 / $3,378.00
| Facility | | $1,153.24 | $1,471.38 | $3,378.00 |
- 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 |