- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $863.65 / $2,318.00 / $11,093.00
| Facility | | $863.65 | $2,318.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,065.00 / $7,890.00 / $37,919.46
| Facility | | $3,065.00 | $7,890.00 | $37,919.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $896.65 / $1,181.47 / $1,772.21
| Facility | | $896.65 | $1,181.47 | $1,772.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,327.21 / $11,327.21 / $13,427.30
| Facility | | $11,327.21 | $11,327.21 | $13,427.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.00 / $12,330.00 / $17,416.00
| Facility | | $5,058.00 | $12,330.00 | $17,416.00 |