- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $981.61 / $2,318.00 / $11,093.00
| Facility | | $981.61 | $2,318.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,411.35 / $7,558.00 / $18,942.00
| Facility | | $1,411.35 | $7,558.00 | $18,942.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,021.45 / $1,345.90 / $2,018.85
| Facility | | $1,021.45 | $1,345.90 | $2,018.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,610.75 / $1,610.75 / $1,909.39
| Facility | | $1,610.75 | $1,610.75 | $1,909.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,364.00 / $6,032.00 / $10,413.00
| Facility | | $3,364.00 | $6,032.00 | $10,413.00 |