- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.52 / $1,130.15 / $11,093.00
| Facility | | $611.52 | $1,130.15 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,309.00 / $6,474.00 / $13,810.27
| Facility | | $3,309.00 | $6,474.00 | $13,810.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.84 / $869.35 / $1,095.69
| Facility | | $596.84 | $869.35 | $1,095.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,610.75 / $1,610.75 / $1,610.75
| Facility | | $1,610.75 | $1,610.75 | $1,610.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $3,870.00 / $5,490.00
| Facility | | $2,400.00 | $3,870.00 | $5,490.00 |