- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.58 / $7,182.00 / $16,467.00
| Facility | | $302.58 | $7,182.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,251.80 / $4,855.42 / $9,578.29
| Facility | | $2,251.80 | $4,855.42 | $9,578.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,106.17 / $2,106.17 / $2,706.47
| Facility | | $2,106.17 | $2,106.17 | $2,706.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $253.14 / $348.82 / $555.92
| Facility | | $253.14 | $348.82 | $555.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,798.00 / $19,665.00
| Facility | | $2,155.00 | $12,798.00 | $19,665.00 |