- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.64 / $1,601.28 / $11,609.00
| Facility | | $485.64 | $1,601.28 | $11,609.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,182.48 / $1,182.48 / $2,710.28
| Facility | | $1,182.48 | $1,182.48 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.64 / $781.81 / $1,176.46
| Facility | | $485.64 | $781.81 | $1,176.46 |
- 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
- $2,295.04 / $2,528.94 / $26,542.00
| Facility | | $2,295.04 | $2,528.94 | $26,542.00 |