- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $3,102.00 / $10,639.00
| Facility | | $789.00 | $3,102.00 | $10,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,821.25 / $9,837.54 / $19,075.16
| Facility | | $5,821.25 | $9,837.54 | $19,075.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.36 / $5,910.08 / $5,910.08
| Facility | | $578.36 | $5,910.08 | $5,910.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $749.68 / $749.68 / $749.68
| Facility | | $749.68 | $749.68 | $749.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,450.40 / $26,542.00 / $31,048.85
| Facility | | $5,450.40 | $26,542.00 | $31,048.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.03 / $881.44 / $1,455.76
| Facility | | $608.03 | $881.44 | $1,455.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $613.16 / $886.67 / $1,465.67
| Facility | | $613.16 | $886.67 | $1,465.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,604.00 / $9,624.00 / $30,253.00
| Facility | | $4,604.00 | $9,624.00 | $30,253.00 |