- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.14 / $2,647.01 / $8,739.36
| Facility | | $103.14 | $2,647.01 | $8,739.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,234.00 / $5,126.00 / $8,240.00
| Facility | | $2,234.00 | $5,126.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.50 / $124.27 / $143.38
| Facility | | $97.50 | $124.27 | $143.38 |
- 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 |