- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $754.01 / $5,108.60 / $11,581.00
| Facility | | $754.01 | $5,108.60 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,425.00 / $4,313.00 / $25,522.00
| Facility | | $1,425.00 | $4,313.00 | $25,522.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.34 / $472.01 / $584.22
| Facility | | $393.34 | $472.01 | $584.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.00 / $4,968.67 / $8,382.37
| Facility | | $530.00 | $4,968.67 | $8,382.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.00 / $4,968.67 / $6,244.51
| Facility | | $530.00 | $4,968.67 | $6,244.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,275.00 / $7,705.00 / $12,871.00
| Facility | | $1,275.00 | $7,705.00 | $12,871.00 |