- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $742.08 / $4,908.57 / $12,237.00
| Facility | | $742.08 | $4,908.57 | $12,237.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $984.20 / $2,689.23 / $6,539.75
| Facility | | $984.20 | $2,689.23 | $6,539.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $624.00 / $624.00 / $624.00
| Facility | | $624.00 | $624.00 | $624.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $441.47 / $757.00 / $3,561.00
| Facility | | $441.47 | $757.00 | $3,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,436.00 / $3,096.00 / $5,565.00
| Facility | | $1,436.00 | $3,096.00 | $5,565.00 |