- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $865.40 / $2,223.00 / $7,838.38
| Facility | | $865.40 | $2,223.00 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,363.84 / $7,916.43 / $12,604.93
| Facility | | $2,363.84 | $7,916.43 | $12,604.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $408.89 / $408.89 / $2,222.25
| Facility | | $408.89 | $408.89 | $2,222.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $341.92 / $565.16 / $847.06
| Facility | | $341.92 | $565.16 | $847.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $936.00 / $6,599.00 / $7,158.00
| Facility | | $936.00 | $6,599.00 | $7,158.00 |