- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $631.05 / $5,866.00 / $16,467.00
| Facility | | $631.05 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,713.16 / $6,304.45 / $10,605.01
| Facility | | $2,713.16 | $6,304.45 | $10,605.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $633.12 / $2,581.96
| Facility | | $505.00 | $633.12 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $462.00 / $630.28 / $1,197.99
| Facility | | $462.00 | $630.28 | $1,197.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |