- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.41 / $2,318.00 / $7,212.00
| Facility | | $443.41 | $2,318.00 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,796.00 / $6,340.00 / $30,900.00
| Facility | | $2,796.00 | $6,340.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $435.28 / $565.86 / $652.91
| Facility | | $435.28 | $565.86 | $652.91 |
- 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
- $3,364.00 / $6,032.00 / $10,413.00
| Facility | | $3,364.00 | $6,032.00 | $10,413.00 |