- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $896.43 / $948.97 / $8,229.00
| Facility | | $896.43 | $948.97 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,049.25 / $9,122.94 / $15,243.15
| Facility | | $5,049.25 | $9,122.94 | $15,243.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $879.96 / $1,207.78 / $1,393.27
| Facility | | $879.96 | $1,207.78 | $1,393.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,060.55 / $1,060.55 / $1,060.55
| Facility | | $1,060.55 | $1,060.55 | $1,060.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.00 / $2,513.00 / $27,879.00
| Facility | | $405.00 | $2,513.00 | $27,879.00 |