- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $698.08 / $3,908.01 / $13,841.56
| Facility | | $698.08 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,973.60 / $6,541.64 / $12,653.65
| Facility | | $4,973.60 | $6,541.64 | $12,653.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,387.40 / $1,387.40 / $1,387.40
| Facility | | $1,387.40 | $1,387.40 | $1,387.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $507.68 / $802.79 / $2,219.92
| Facility | | $507.68 | $802.79 | $2,219.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.86 / $1,481.32 / $1,987.64
| Facility | | $1,061.86 | $1,481.32 | $1,987.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |