- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.98 / $4,424.18 / $14,644.00
| Facility | | $382.98 | $4,424.18 | $14,644.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,026.16 / $4,945.92 / $8,525.77
| Facility | | $2,026.16 | $4,945.92 | $8,525.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $574.08 / $715.00 / $5,740.31
| Facility | | $574.08 | $715.00 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.98 / $584.04 / $937.57
| Facility | | $382.98 | $584.04 | $937.57 |
- 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 |