- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $2,398.83 / $9,772.37
| Facility | | $2,290.87 | $2,398.83 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $1,737.80 / $3,019.95
| Facility | | $1,584.89 | $1,737.80 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $1,819.70 / $1,819.70
| Facility | | $1,819.70 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $9,549.93 / $9,549.93
| Facility | | $9,549.93 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $9,549.93 / $9,549.93
| Facility | | $9,549.93 | $9,549.93 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $912.01
| Facility | | $575.44 | $575.44 | $912.01 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | 50 | $851.14 | $851.14 | $851.14 |