- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,272.80 / $1,272.80 / $1,272.80
| Facility | | $1,272.80 | $1,272.80 | $1,272.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,184.29 / $7,741.18 / $13,020.23
| Facility | | $4,184.29 | $7,741.18 | $13,020.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,149.23 / $4,465.99 / $10,743.55
| Facility | | $3,149.23 | $4,465.99 | $10,743.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,560.09 / $4,082.99 / $8,459.49
| Facility | | $2,560.09 | $4,082.99 | $8,459.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,625.54 / $2,266.69 / $3,500.00
| Facility | | $1,625.54 | $2,266.69 | $3,500.00 |
- 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 |