- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $459.35 / $1,338.00 / $8,413.00
| Facility | | $459.35 | $1,338.00 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,297.06 / $2,297.06 / $2,330.58
| Facility | | $2,297.06 | $2,297.06 | $2,330.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $459.35 / $697.25 / $1,038.13
| Facility | | $459.35 | $697.25 | $1,038.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,718.80 / $8,957.00 / $26,542.00
| Facility | | $1,718.80 | $8,957.00 | $26,542.00 |