- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.06 / $5,621.00 / $9,062.00
| Facility | | $193.06 | $5,621.00 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,665.01 / $4,049.54 / $8,116.91
| Facility | | $1,665.01 | $4,049.54 | $8,116.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $2,048.92 / $2,632.90
| Facility | | $505.00 | $2,048.92 | $2,632.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $160.88 / $235.00 / $352.31
| Facility | | $160.88 | $235.00 | $352.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.00 / $10,257.00 / $16,249.00
| Facility | | $791.00 | $10,257.00 | $16,249.00 |