- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $905.46 / $6,282.00 / $9,000.61
| Facility | | $905.46 | $6,282.00 | $9,000.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,352.10 / $16,192.78 / $36,581.76
| Facility | | $4,352.10 | $16,192.78 | $36,581.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,141.04 / $3,036.25 / $7,304.12
| Facility | | $2,141.04 | $3,036.25 | $7,304.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,740.51 / $2,775.86 / $5,751.28
| Facility | | $1,740.51 | $2,775.86 | $5,751.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,239.83 / $1,774.80 / $12,002.00
| Facility | | $1,239.83 | $1,774.80 | $12,002.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |