- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $255.08 / $474.17 / $3,638.00
| Facility | | $255.08 | $474.17 | $3,638.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.89 / $5,307.65 / $11,503.06
| Facility | | $1,145.89 | $5,307.65 | $11,503.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,282.10 / $1,819.12 / $4,376.14
| Facility | | $1,282.10 | $1,819.12 | $4,376.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,042.80 / $1,663.12 / $3,445.79
| Facility | | $1,042.80 | $1,663.12 | $3,445.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $282.27 / $592.20 / $1,394.89
| Facility | | $282.27 | $592.20 | $1,394.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.00 / $7,770.00 / $10,734.22
| Facility | | $2,412.00 | $7,770.00 | $10,734.22 |