- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $543.91 / $1,245.00 / $10,561.00
| Facility | | $543.91 | $1,245.00 | $10,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,226.87 / $2,226.87 / $2,259.36
| Facility | | $2,226.87 | $2,226.87 | $2,259.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $2,710.28
| Facility | | $748.70 | $748.70 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $543.91 / $663.67 / $1,229.26
| Facility | | $543.91 | $663.67 | $1,229.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,103.67 / $8,957.00 / $26,542.00
| Facility | | $2,103.67 | $8,957.00 | $26,542.00 |