- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,737.80 / $3,467.37
| Facility | | $851.14 | $1,737.80 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $891.25 / $2,511.89
| Facility | | $794.33 | $891.25 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $2,570.40 / $2,570.40
| Facility | | $2,570.40 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $1,737.80 / $2,454.71
| Facility | | $851.14 | $1,737.80 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,888.44 / $5,888.44
| Facility | | $977.24 | $5,888.44 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $912.01 / $1,513.56
| Facility | | $831.76 | $912.01 | $1,513.56 |