- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,492.60 / $1,492.60 / $1,492.60
| Facility | | $1,492.60 | $1,492.60 | $1,492.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,106.76 / $2,401.69 / $12,463.98
| Facility | | $1,106.76 | $2,401.69 | $12,463.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,474.46 / $5,422.73 / $13,045.12
| Facility | | $3,474.46 | $5,422.73 | $13,045.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,010.93 / $4,948.60 / $10,271.75
| Facility | | $3,010.93 | $4,948.60 | $10,271.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,585.58 / $2,734.26 / $4,677.00
| Facility | | $1,585.58 | $2,734.26 | $4,677.00 |
- 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 |