- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $974.60 / $974.60 / $2,168.00
| Facility | | $974.60 | $974.60 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $370.96 / $811.46 / $7,247.81
| Facility | | $370.96 | $811.46 | $7,247.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,352.91 / $3,338.45 / $8,031.08
| Facility | | $2,352.91 | $3,338.45 | $8,031.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,139.01 / $3,052.14 / $6,323.69
| Facility | | $2,139.01 | $3,052.14 | $6,323.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $913.42 / $1,644.16 / $2,622.08
| Facility | | $913.42 | $1,644.16 | $2,622.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.00 / $1,727.00 / $2,883.00
| Facility | | $382.00 | $1,727.00 | $2,883.00 |