- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $2,025.58 / $8,229.00
| Facility | | $860.00 | $2,025.58 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,503.33 / $8,650.50 / $13,595.06
| Facility | | $4,503.33 | $8,650.50 | $13,595.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,955.88 / $2,666.03 / $3,075.45
| Facility | | $1,955.88 | $2,666.03 | $3,075.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,703.51 / $2,369.53 / $2,369.53
| Facility | | $1,703.51 | $2,369.53 | $2,369.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $4,298.00 / $30,001.00
| Facility | | $599.00 | $4,298.00 | $30,001.00 |