- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.87 / $6,735.00 / $10,924.00
| Facility | | $521.87 | $6,735.00 | $10,924.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.36 / $2,503.36 / $2,539.89
| Facility | | $2,503.36 | $2,503.36 | $2,539.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $521.87 / $781.15 / $1,208.66
| Facility | | $521.87 | $781.15 | $1,208.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,989.16 / $8,957.00 / $26,542.00
| Facility | | $1,989.16 | $8,957.00 | $26,542.00 |