- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $399.44 / $5,043.47 / $9,727.00
| Facility | | $399.44 | $5,043.47 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,308.63 / $5,057.09 / $8,656.54
| Facility | | $2,308.63 | $5,057.09 | $8,656.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $582.45 / $2,581.96
| Facility | | $505.00 | $582.45 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $399.44 / $606.19 / $952.28
| Facility | | $399.44 | $606.19 | $952.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |