- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $644.14 / $644.14 / $2,168.00
| Facility | | $644.14 | $644.14 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,093.28 / $6,529.72 / $14,158.79
| Facility | | $3,093.28 | $6,529.72 | $14,158.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.75 / $2,342.29 / $5,634.69
| Facility | | $1,500.75 | $2,342.29 | $5,634.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.54 / $2,137.48 / $4,436.76
| Facility | | $1,300.54 | $2,137.48 | $4,436.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.66 / $1,181.69 / $2,159.23
| Facility | | $687.66 | $1,181.69 | $2,159.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,623.00 / $4,746.00 / $8,812.00
| Facility | | $1,623.00 | $4,746.00 | $8,812.00 |