- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,249.21 / $1,249.21 / $1,249.21
| Facility | | $1,249.21 | $1,249.21 | $1,249.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,647.11 / $6,277.90 / $11,287.17
| Facility | | $2,647.11 | $6,277.90 | $11,287.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,172.81 / $4,499.43 / $10,824.00
| Facility | | $3,172.81 | $4,499.43 | $10,824.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,579.26 / $4,113.56 / $8,522.84
| Facility | | $2,579.26 | $4,113.56 | $8,522.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,732.72 / $2,270.23 / $3,509.20
| Facility | | $1,732.72 | $2,270.23 | $3,509.20 |
- 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 |