- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $307.30 / $1,154.73 / $2,525.00
| Facility | | $307.30 | $1,154.73 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,571.32 / $11,500.72 / $26,641.14
| Facility | | $1,571.32 | $11,500.72 | $26,641.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,453.14 / $4,114.83 / $9,898.78
| Facility | | $2,453.14 | $4,114.83 | $9,898.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,115.92 / $3,627.93 / $7,794.31
| Facility | | $2,115.92 | $3,627.93 | $7,794.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.60 / $1,096.83 / $3,327.30
| Facility | | $393.60 | $1,096.83 | $3,327.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,100.00 / $5,499.00 / $9,810.00
| Facility | | $2,100.00 | $5,499.00 | $9,810.00 |