- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,005.00 / $10,563.53 / $20,928.72
| Facility | | $5,005.00 | $10,563.53 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,889.38 / $7,684.16 / $14,983.55
| Facility | | $5,889.38 | $7,684.16 | $14,983.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,141.50 / $3,141.50 / $3,141.50
| Facility | | $3,141.50 | $3,141.50 | $3,141.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $622.23 / $1,307.67 / $7,934.00
| Facility | | $622.23 | $1,307.67 | $7,934.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,086.21 / $1,732.26 / $4,133.42
| Facility | | $1,086.21 | $1,732.26 | $4,133.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |