- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $933.25 / $933.25
| Facility | | $218.78 | $933.25 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $3,801.89 / $8,709.64
| Facility | | $1,778.28 | $3,801.89 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $3,548.13 / $8,511.38
| Facility | | $2,187.76 | $3,548.13 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $3,388.44 / $6,760.83
| Facility | | $2,754.23 | $3,388.44 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $933.25 / $2,754.23
| Facility | | $257.04 | $933.25 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $3,467.37 / $6,456.54
| Facility | | $1,445.44 | $3,467.37 | $6,456.54 |