- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $479.13 / $2,303.00 / $6,681.00
| Facility | | $479.13 | $2,303.00 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,327.00 / $2,706.00 / $3,620.00
| Facility | | $1,327.00 | $2,706.00 | $3,620.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.00 / $1,087.39 / $1,992.00
| Facility | | $455.00 | $1,087.39 | $1,992.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,302.06 / $4,901.45 / $16,394.00
| Facility | | $1,302.06 | $4,901.45 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $875.00 / $2,257.00 / $4,099.00
| Facility | | $875.00 | $2,257.00 | $4,099.00 |