- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $990.13 / $9,062.00 / $18,276.00
| Facility | | $990.13 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,566.14 / $9,602.04 / $16,952.09
| Facility | | $4,566.14 | $9,602.04 | $16,952.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $780.00 / $4,769.93
| Facility | | $505.00 | $780.00 | $4,769.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $909.04 / $1,152.80 / $1,912.53
| Facility | | $909.04 | $1,152.80 | $1,912.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,223.00 / $23,485.00
| Facility | | $2,912.00 | $16,223.00 | $23,485.00 |