- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $840.23 / $4,450.00 / $8,031.00
| Facility | | $840.23 | $4,450.00 | $8,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,807.00 / $4,613.09 / $8,931.00
| Facility | | $2,807.00 | $4,613.09 | $8,931.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $992.64 / $1,409.72 / $1,623.02
| Facility | | $992.64 | $1,409.72 | $1,623.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $837.20 / $1,077.65 / $1,552.85
| Facility | | $837.20 | $1,077.65 | $1,552.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $911.00 / $5,307.00 / $8,879.00
| Facility | | $911.00 | $5,307.00 | $8,879.00 |