- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $543.04 / $5,107.20 / $9,727.00
| Facility | | $543.04 | $5,107.20 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.99 / $1,150.29 / $1,952.01
| Facility | | $611.99 | $1,150.29 | $1,952.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,248.31 / $1,248.31 / $1,604.11
| Facility | | $1,248.31 | $1,248.31 | $1,604.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.85 / $773.71 / $1,160.27
| Facility | | $524.85 | $773.71 | $1,160.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $6,607.00 / $8,667.00
| Facility | | $659.00 | $6,607.00 | $8,667.00 |