- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $702.85 / $2,451.00 / $9,516.00
| Facility | | $702.85 | $2,451.00 | $9,516.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,670.00 / $5,544.00 / $30,285.00
| Facility | | $2,670.00 | $5,544.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $432.64 / $555.26 / $687.26
| Facility | | $432.64 | $555.26 | $687.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $554.63 / $554.63 / $2,525.75
| Facility | | $554.63 | $554.63 | $2,525.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,840.00 / $5,625.00 / $7,847.00
| Facility | | $2,840.00 | $5,625.00 | $7,847.00 |