- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.14 / $889.22 / $8,413.00
| Facility | | $409.14 | $889.22 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $8,304.24
| Facility | | $606.10 | $606.10 | $8,304.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.14 / $684.11 / $1,034.24
| Facility | | $409.14 | $684.11 | $1,034.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,545.00 / $22,780.00
| Facility | | $4,015.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,950.52 / $2,142.30 / $26,542.00
| Facility | | $1,950.52 | $2,142.30 | $26,542.00 |