- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $696.90 / $902.75 / $1,156.80
| Facility | | $696.90 | $902.75 | $1,156.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,014.00 / $8,584.00 / $11,253.00
| Facility | | $4,014.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $982.75 / $1,472.30 / $1,698.39
| Facility | | $982.75 | $1,472.30 | $1,698.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,291.78 / $1,291.78 / $1,291.78
| Facility | | $1,291.78 | $1,291.78 | $1,291.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $973.00 / $4,639.00 / $12,296.00
| Facility | | $973.00 | $4,639.00 | $12,296.00 |