- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.06 / $9,054.58 / $11,252.86
| Facility | | $478.06 | $9,054.58 | $11,252.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,044.00 / $10,366.00 / $28,794.00
| Facility | | $5,044.00 | $10,366.00 | $28,794.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $474.90 / $605.27 / $698.39
| Facility | | $474.90 | $605.27 | $698.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,833.32 / $3,833.32 / $3,833.32
| Facility | | $3,833.32 | $3,833.32 | $3,833.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $12,296.00 / $17,380.00
| Facility | | $5,431.00 | $12,296.00 | $17,380.00 |