- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $775.24 / $3,017.88 / $7,756.35
| Facility | | $775.24 | $3,017.88 | $7,756.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,234.00 / $5,570.00 / $13,758.00
| Facility | | $2,234.00 | $5,570.00 | $13,758.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $767.53 / $1,053.47 / $1,580.21
| Facility | | $767.53 | $1,053.47 | $1,580.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,116.34 / $2,116.34 / $2,508.71
| Facility | | $2,116.34 | $2,116.34 | $2,508.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,719.19 / $7,672.00 / $11,284.00
| Facility | | $2,719.19 | $7,672.00 | $11,284.00 |