- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $871.50 / $2,869.25 / $8,101.00
| Facility | | $871.50 | $2,869.25 | $8,101.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,597.30 / $5,813.21 / $6,778.72
| Facility | | $2,597.30 | $5,813.21 | $6,778.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $442.00 / $442.00 / $442.00
| Facility | | $442.00 | $442.00 | $442.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $717.61 / $1,124.57 / $11,642.00
| Facility | | $717.61 | $1,124.57 | $11,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,269.00 / $6,407.00 / $12,224.00
| Facility | | $2,269.00 | $6,407.00 | $12,224.00 |