- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $946.31 / $8,960.00 / $16,467.00
| Facility | | $946.31 | $8,960.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,768.35 / $7,239.95 / $12,392.04
| Facility | | $2,768.35 | $7,239.95 | $12,392.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.00 / $2,106.17 / $2,706.47
| Facility | | $815.00 | $2,106.17 | $2,706.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $757.81 / $1,034.96 / $1,698.25
| Facility | | $757.81 | $1,034.96 | $1,698.25 |
- 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 |