- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $7,762.47
| Facility | | $707.95 | $707.95 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $11,748.98 / $26,915.35
| Facility | | $4,265.80 | $11,748.98 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,630.27 / $6,309.57
| Facility | | $1,862.09 | $2,630.27 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $2,511.89 / $4,897.79
| Facility | | $1,995.26 | $2,511.89 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $1,445.44 / $10,964.78
| Facility | | $794.33 | $1,445.44 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $9,120.11 / $14,791.08
| Facility | | $4,466.84 | $9,120.11 | $14,791.08 |