- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.50 / $1,941.00 / $7,212.00
| Facility | | $470.50 | $1,941.00 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,234.00 / $5,570.00 / $15,154.00
| Facility | | $2,234.00 | $5,570.00 | $15,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.02 / $645.12 / $967.68
| Facility | | $470.02 | $645.12 | $967.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,705.12 / $4,705.12 / $5,577.46
| Facility | | $4,705.12 | $4,705.12 | $5,577.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,348.00 / $12,569.00
| Facility | | $3,932.00 | $8,348.00 | $12,569.00 |