- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $2,691.53 / $4,365.16
| Facility | | $933.25 | $2,691.53 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $5,248.07 / $7,413.10
| Facility | | $3,090.30 | $5,248.07 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $1,288.25 / $1,288.25
| Facility | | $39.81 | $1,288.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $812.83 / $2,454.71
| Facility | | $489.78 | $812.83 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $1,174.90 / $5,754.40
| Facility | | $371.54 | $1,174.90 | $5,754.40 |