- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.83 / $1,415.32 / $7,278.00
| Facility | | $584.83 | $1,415.32 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,710.28
| Facility | | $530.04 | $530.04 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $584.83 / $804.00 / $1,281.00
| Facility | | $584.83 | $804.00 | $1,281.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,240.96 / $8,957.00 / $16,394.00
| Facility | | $2,240.96 | $8,957.00 | $16,394.00 |