- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $568.24 / $2,662.64 / $8,687.93
| Facility | | $568.24 | $2,662.64 | $8,687.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $8,339.06
| Facility | | $606.10 | $606.10 | $8,339.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $568.24 / $780.00 / $1,142.16
| Facility | | $568.24 | $780.00 | $1,142.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,227.92 / $26,542.00 / $27,559.10
| Facility | | $2,227.92 | $26,542.00 | $27,559.10 |