- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $670.34 / $2,082.00 / $5,607.00
| Facility | | $670.34 | $2,082.00 | $5,607.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,753.58 / $4,539.27 / $6,981.81
| Facility | | $1,753.58 | $4,539.27 | $6,981.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $466.93 / $2,782.79 / $2,782.79
| Facility | | $466.93 | $2,782.79 | $2,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $546.08 / $731.00 / $1,936.96
| Facility | | $546.08 | $731.00 | $1,936.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $746.00 / $2,415.00 / $6,661.00
| Facility | | $746.00 | $2,415.00 | $6,661.00 |