- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $729.27 / $2,161.19 / $16,467.00
| Facility | | $729.27 | $2,161.19 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,956.60 / $9,829.40 / $17,877.47
| Facility | | $3,956.60 | $9,829.40 | $17,877.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $732.07 / $7,373.70
| Facility | | $580.00 | $732.07 | $7,373.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.00 / $784.00 / $1,385.59
| Facility | | $660.00 | $784.00 | $1,385.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,628.00 / $20,341.00 / $27,446.00
| Facility | | $4,628.00 | $20,341.00 | $27,446.00 |