- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $679.81 / $679.81 / $6,781.00
| Facility | | $679.81 | $679.81 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,978.00 / $5,806.78 / $11,558.36
| Facility | | $2,978.00 | $5,806.78 | $11,558.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,808.34 / $2,564.44 / $6,169.14
| Facility | | $1,808.34 | $2,564.44 | $6,169.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,470.05 / $2,344.52 / $4,857.59
| Facility | | $1,470.05 | $2,344.52 | $4,857.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $905.51 / $1,385.02 / $7,992.30
| Facility | | $905.51 | $1,385.02 | $7,992.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,293.00 / $6,652.00 / $9,810.00
| Facility | | $3,293.00 | $6,652.00 | $9,810.00 |