- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $2,454.71 / $6,918.31
| Facility | | $537.03 | $2,454.71 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $6,456.54 / $12,022.64
| Facility | | $2,630.27 | $6,456.54 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.04 / $257.04 / $257.04
| Facility | | $257.04 | $257.04 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $3,630.78 / $3,630.78
| Facility | | $3,630.78 | $3,630.78 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $19,498.45 / $19,498.45
| Facility | | $14,454.40 | $19,498.45 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $512.86 / $2,951.21
| Facility | | $302.00 | $512.86 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.40 / $426.58 / $758.58
| Facility | | $288.40 | $426.58 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,511.89 / $4,897.79
| Facility | | $724.44 | $2,511.89 | $4,897.79 |