- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $3,019.95 / $7,413.10
| Facility | | $794.33 | $3,019.95 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,754.23 / $5,248.07
| Facility | | $1,548.82 | $2,754.23 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $1,737.80 / $1,737.80
| Facility | | $275.42 | $1,737.80 | $1,737.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $28,840.32 / $28,840.32
| Facility | | $5,248.07 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $467.74 / $3,715.35
| Facility | | $275.42 | $467.74 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $398.11 / $660.69
| Facility | | $275.42 | $398.11 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,073.80 / $8,912.51
| Facility | | $1,380.38 | $4,073.80 | $8,912.51 |