- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $184.70 / $7,212.00 / $12,064.81
| Facility | | $184.70 | $7,212.00 | $12,064.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,266.00 / $5,570.00 / $13,810.27
| Facility | | $2,266.00 | $5,570.00 | $13,810.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $174.30 / $222.14 / $256.32
| Facility | | $174.30 | $222.14 | $256.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,158.09 / $2,158.09 / $2,158.09
| Facility | | $2,158.09 | $2,158.09 | $2,158.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,364.00 / $6,094.00 / $10,413.00
| Facility | | $3,364.00 | $6,094.00 | $10,413.00 |