- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $2,511.89 / $5,754.40
| Facility | | $331.13 | $2,511.89 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,677.35 / $8,912.51
| Facility | | $2,238.72 | $4,677.35 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $2,187.76 / $2,187.76
| Facility | | $2,187.76 | $2,187.76 | $2,187.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $363.08 / $870.96
| Facility | | $208.93 | $363.08 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $660.69 / $1,380.38
| Facility | | $177.83 | $660.69 | $1,380.38 |