- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $2,691.53 / $8,317.64
| Facility | | $870.96 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $6,456.54 / $9,772.37
| Facility | | $2,454.71 | $6,456.54 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $13,803.84 / $19,952.62
| Facility | | $12,302.69 | $13,803.84 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $34,673.69 / $34,673.69
| Facility | | $54.95 | $34,673.69 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $7,585.78 / $12,302.69
| Facility | | $4,365.16 | $7,585.78 | $12,302.69 |