- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $8,912.51 / $12,022.64
| Facility | | $346.74 | $8,912.51 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $12,302.69 / $30,199.52
| Facility | | $3,388.44 | $12,302.69 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $323.59 / $380.19
| Facility | | $323.59 | $323.59 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $21,379.62 / $21,379.62
| Facility | | $21,379.62 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $21,379.62 / $21,379.62
| Facility | | $21,379.62 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $3,090.30 / $6,760.83
| Facility | | $1,479.11 | $3,090.30 | $6,760.83 |