- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $667.06 / $5,866.00 / $16,467.00
| Facility | | $667.06 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,347.39 / $5,205.85 / $8,724.34
| Facility | | $2,347.39 | $5,205.85 | $8,724.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $664.73 / $2,581.96
| Facility | | $505.00 | $664.73 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $629.57 / $787.35 / $1,257.47
| Facility | | $629.57 | $787.35 | $1,257.47 |
- 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 |