- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $762.37 / $1,418.76 / $7,212.00
| Facility | | $762.37 | $1,418.76 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,266.00 / $5,570.00 / $13,810.27
| Facility | | $2,266.00 | $5,570.00 | $13,810.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $749.25 / $1,091.34 / $1,175.30
| Facility | | $749.25 | $1,091.34 | $1,175.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,623.15 / $2,623.15 / $2,623.15
| Facility | | $2,623.15 | $2,623.15 | $2,623.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,025.00 / $11,038.00
| Facility | | $3,932.00 | $8,025.00 | $11,038.00 |