- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $777.07 / $8,783.00 / $16,639.00
| Facility | | $777.07 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,049.08 / $15,050.77 / $25,744.16
| Facility | | $7,049.08 | $15,050.77 | $25,744.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $775.58 / $7,745.65
| Facility | | $580.00 | $775.58 | $7,745.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $697.37 / $836.60 / $1,478.63
| Facility | | $697.37 | $836.60 | $1,478.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |