- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $703.20 / $2,318.00 / $11,093.00
| Facility | | $703.20 | $2,318.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,890.00 / $30,900.00
| Facility | | $3,473.00 | $7,890.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $709.26 / $934.56 / $1,401.84
| Facility | | $709.26 | $934.56 | $1,401.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,385.78 / $6,385.78 / $7,569.71
| Facility | | $6,385.78 | $6,385.78 | $7,569.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.00 / $12,330.00 / $17,416.00
| Facility | | $5,058.00 | $12,330.00 | $17,416.00 |