- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $1,347.94 / $8,229.00
| Facility | | $860.00 | $1,347.94 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,212.00 / $9,592.68 / $21,957.82
| Facility | | $7,212.00 | $9,592.68 | $21,957.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,065.13 / $1,461.33 / $1,685.76
| Facility | | $1,065.13 | $1,461.33 | $1,685.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,134.97 / $1,282.40 / $1,282.40
| Facility | | $1,134.97 | $1,282.40 | $1,282.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $4,539.00 / $10,113.00
| Facility | | $842.00 | $4,539.00 | $10,113.00 |