- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $710.41 / $710.41 / $4,828.00
| Facility | | $710.41 | $710.41 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,035.56 / $5,572.33 / $11,102.27
| Facility | | $3,035.56 | $5,572.33 | $11,102.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,708.91 / $2,424.69 / $5,832.95
| Facility | | $1,708.91 | $2,424.69 | $5,832.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,553.56 / $2,216.76 / $4,592.88
| Facility | | $1,553.56 | $2,216.76 | $4,592.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $768.43 / $1,200.58 / $2,629.32
| Facility | | $768.43 | $1,200.58 | $2,629.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,388.00 / $3,500.00 / $6,361.00
| Facility | | $1,388.00 | $3,500.00 | $6,361.00 |