- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $740.25 / $2,522.10 / $16,467.00
| Facility | | $740.25 | $2,522.10 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.00 / $3,989.66 / $6,738.82
| Facility | | $1,737.00 | $3,989.66 | $6,738.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $731.84 / $2,581.96
| Facility | | $580.00 | $731.84 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.36 / $851.72 / $1,290.27
| Facility | | $612.36 | $851.72 | $1,290.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.00 / $6,607.00 / $8,667.00
| Facility | | $729.00 | $6,607.00 | $8,667.00 |