- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $1,096.48 / $9,332.54
| Facility | | $457.09 | $1,096.48 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $11,220.18 / $26,302.68
| Facility | | $2,630.27 | $11,220.18 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,659.59 / $3,981.07
| Facility | | $1,174.90 | $1,659.59 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.25 / $1,621.81 / $3,162.28
| Facility | | $1,288.25 | $1,621.81 | $3,162.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $954.99 / $12,022.64
| Facility | | $562.34 | $954.99 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $10,000.00 / $15,135.61
| Facility | | $4,897.79 | $10,000.00 | $15,135.61 |