- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $5,495.41 / $6,606.93
| Facility | | $645.65 | $5,495.41 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $724.44 / $891.25
| Facility | | $724.44 | $724.44 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,174.90 / $2,290.87
| Facility | | $1,174.90 | $1,174.90 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $30,199.52 / $30,902.95
| Facility | | $22,908.68 | $30,199.52 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $4,466.84 / $16,982.44
| Facility | | $4,466.84 | $4,466.84 | $16,982.44 |