- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $746.78 / $746.78 / $6,781.00
| Facility | | $746.78 | $746.78 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,204.39 / $6,134.65 / $11,966.76
| Facility | | $3,204.39 | $6,134.65 | $11,966.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,815.83 / $2,576.40 / $6,197.87
| Facility | | $1,815.83 | $2,576.40 | $6,197.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,650.75 / $2,355.44 / $4,880.21
| Facility | | $1,650.75 | $2,355.44 | $4,880.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $646.41 / $1,277.50 / $4,746.00
| Facility | | $646.41 | $1,277.50 | $4,746.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.00 / $4,746.00 / $8,812.00
| Facility | | $2,412.00 | $4,746.00 | $8,812.00 |