- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $310.02 / $4,846.00 / $11,093.00
| Facility | | $310.02 | $4,846.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.00 / $5,948.00 / $9,462.00
| Facility | | $2,754.00 | $5,948.00 | $9,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.85 / $424.73 / $637.10
| Facility | | $300.85 | $424.73 | $637.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,243.79 / $2,243.79 / $2,243.79
| Facility | | $2,243.79 | $2,243.79 | $2,243.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,364.00 / $6,094.00 / $10,413.00
| Facility | | $3,364.00 | $6,094.00 | $10,413.00 |