- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $383.40 / $383.40 / $4,828.00
| Facility | | $383.40 | $383.40 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,702.80 / $5,239.08 / $11,110.48
| Facility | | $1,702.80 | $5,239.08 | $11,110.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,016.61 / $1,441.68 / $3,468.16
| Facility | | $1,016.61 | $1,441.68 | $3,468.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $826.43 / $1,318.04 / $2,730.84
| Facility | | $826.43 | $1,318.04 | $2,730.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.73 / $808.19 / $7,729.00
| Facility | | $506.73 | $808.19 | $7,729.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |