- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.62 / $2,741.01 / $7,212.00
| Facility | | $912.62 | $2,741.01 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,796.00 / $6,340.00 / $15,727.00
| Facility | | $2,796.00 | $6,340.00 | $15,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $907.47 / $1,156.58 / $1,334.52
| Facility | | $907.47 | $1,156.58 | $1,334.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,379.37 / $3,379.37 / $3,379.37
| Facility | | $3,379.37 | $3,379.37 | $3,379.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,025.00 / $11,038.00
| Facility | | $3,932.00 | $8,025.00 | $11,038.00 |