- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.75 / $3,614.21 / $16,467.00
| Facility | | $900.75 | $3,614.21 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,491.37 / $6,405.07 / $11,041.04
| Facility | | $2,491.37 | $6,405.07 | $11,041.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $886.94 / $2,581.96
| Facility | | $715.00 | $886.94 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.67 / $1,103.13 / $1,626.61
| Facility | | $832.67 | $1,103.13 | $1,626.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |