- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.92 / $3,064.34 / $11,093.00
| Facility | | $640.92 | $3,064.34 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,153.00 / $7,230.00 / $18,942.00
| Facility | | $1,153.00 | $7,230.00 | $18,942.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $664.66 / $875.78 / $1,313.67
| Facility | | $664.66 | $875.78 | $1,313.67 |
- 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 |