- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $367.52 / $2,318.00 / $14,063.00
| Facility | | $367.52 | $2,318.00 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.00 / $6,653.00 / $11,752.00
| Facility | | $2,754.00 | $6,653.00 | $11,752.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $369.55 / $507.22 / $760.83
| Facility | | $369.55 | $507.22 | $760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,123.45 / $1,123.45 / $1,331.74
| Facility | | $1,123.45 | $1,123.45 | $1,331.74 |
- 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 |