- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.67 / $3,508.40 / $9,062.00
| Facility | | $226.67 | $3,508.40 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,090.26 / $4,813.35 / $9,166.12
| Facility | | $1,090.26 | $4,813.35 | $9,166.12 |
- 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
- $189.55 / $292.83 / $452.58
| Facility | | $189.55 | $292.83 | $452.58 |
- 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 |