- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,163.56 / $1,288.26 / $4,846.00
| Facility | | $1,163.56 | $1,288.26 | $4,846.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,027.00 / $5,444.94 / $7,747.00
| Facility | | $3,027.00 | $5,444.94 | $7,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,073.55 / $1,395.62 / $1,610.33
| Facility | | $1,073.55 | $1,395.62 | $1,610.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.00 / $761.00 / $1,378.15
| Facility | | $761.00 | $761.00 | $1,378.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.00 / $5,076.00 / $10,396.00
| Facility | | $612.00 | $5,076.00 | $10,396.00 |