- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.81 / $675.81 / $675.81
| Facility | | $675.81 | $675.81 | $675.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,178.08 / $3,144.69 / $6,087.06
| Facility | | $1,178.08 | $3,144.69 | $6,087.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.17 / $2,472.48 / $5,947.89
| Facility | | $1,584.17 | $2,472.48 | $5,947.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,372.82 / $2,256.30 / $4,683.38
| Facility | | $1,372.82 | $2,256.30 | $4,683.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $727.64 / $1,240.59 / $2,163.14
| Facility | | $727.64 | $1,240.59 | $2,163.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $796.00 / $3,500.00 / $8,152.00
| Facility | | $796.00 | $3,500.00 | $8,152.00 |