- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $296.70 / $3,651.81 / $8,017.00
| Facility | | $296.70 | $3,651.81 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,450.00 / $5,951.00 / $8,887.00
| Facility | | $2,450.00 | $5,951.00 | $8,887.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,791.86 / $6,988.21 / $12,402.91
| Facility | | $2,791.86 | $6,988.21 | $12,402.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $322.19 / $4,068.00 / $8,427.00
| Facility | | $322.19 | $4,068.00 | $8,427.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $313.06 / $313.06 / $313.06
| Facility | | $313.06 | $313.06 | $313.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $166.70 / $180.97 / $344.43
| Facility | | $166.70 | $180.97 | $344.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.00 / $2,884.00 / $6,000.00
| Facility | | $1,122.00 | $2,884.00 | $6,000.00 |