- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $481.08 / $2,039.39 / $7,212.00
| Facility | | $481.08 | $2,039.39 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,234.00 / $5,570.00 / $13,758.00
| Facility | | $2,234.00 | $5,570.00 | $13,758.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.93 / $613.51 / $707.90
| Facility | | $471.93 | $613.51 | $707.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,116.34 / $2,116.34 / $2,508.71
| Facility | | $2,116.34 | $2,116.34 | $2,508.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,364.00 / $6,032.00 / $10,413.00
| Facility | | $3,364.00 | $6,032.00 | $10,413.00 |