- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $661.10 / $1,245.00 / $8,413.00
| Facility | | $661.10 | $1,245.00 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,665.09 / $3,665.09 / $3,718.57
| Facility | | $3,665.09 | $3,665.09 | $3,718.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $8,332.29
| Facility | | $606.10 | $606.10 | $8,332.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $661.10 / $975.00 / $1,497.09
| Facility | | $661.10 | $975.00 | $1,497.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,546.36 / $26,542.00 / $27,536.75
| Facility | | $2,546.36 | $26,542.00 | $27,536.75 |