- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.42 / $495.42 / $6,575.00
| Facility | | $495.42 | $495.42 | $6,575.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,206.67 / $7,465.39 / $14,249.16
| Facility | | $4,206.67 | $7,465.39 | $14,249.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,206.33 / $1,711.63 / $4,117.55
| Facility | | $1,206.33 | $1,711.63 | $4,117.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.67 / $1,564.84 / $3,242.16
| Facility | | $1,096.67 | $1,564.84 | $3,242.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $539.89 / $858.40 / $3,991.00
| Facility | | $539.89 | $858.40 | $3,991.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,121.00 / $5,499.00 / $9,810.00
| Facility | | $3,121.00 | $5,499.00 | $9,810.00 |