- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,209.82 / $2,209.82 / $2,209.82
| Facility | | $2,209.82 | $2,209.82 | $2,209.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,584.70 / $9,857.11 / $19,500.98
| Facility | | $4,584.70 | $9,857.11 | $19,500.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,590.95 / $7,928.66 / $19,073.46
| Facility | | $5,590.95 | $7,928.66 | $19,073.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,545.04 / $7,248.70 / $15,018.48
| Facility | | $4,545.04 | $7,248.70 | $15,018.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,953.52 / $3,937.72 / $6,271.73
| Facility | | $2,953.52 | $3,937.72 | $6,271.73 |
- 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 |