- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $901.81 / $8,783.00 / $16,639.00
| Facility | | $901.81 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,860.32 / $10,437.45 / $18,018.52
| Facility | | $4,860.32 | $10,437.45 | $18,018.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $890.00 / $8,289.45
| Facility | | $580.00 | $890.00 | $8,289.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $845.50 / $1,133.22 / $1,753.92
| Facility | | $845.50 | $1,133.22 | $1,753.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,628.00 / $20,341.00 / $27,446.00
| Facility | | $4,628.00 | $20,341.00 | $27,446.00 |