- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $855.50 / $905.30 / $8,229.00
| Facility | | $855.50 | $905.30 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,049.25 / $9,122.94 / $15,243.15
| Facility | | $5,049.25 | $9,122.94 | $15,243.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $839.46 / $1,152.20 / $1,329.15
| Facility | | $839.46 | $1,152.20 | $1,329.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,016.10 / $1,016.10 / $1,016.10
| Facility | | $1,016.10 | $1,016.10 | $1,016.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.00 / $2,513.00 / $27,879.00
| Facility | | $405.00 | $2,513.00 | $27,879.00 |