- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $2,630.27 / $8,317.64
| Facility | | $851.14 | $2,630.27 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $10,715.19 / $11,220.18
| Facility | | $8,128.31 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,122.02 / $1,479.11
| Facility | | $912.01 | $1,122.02 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,698.24 / $1,698.24
| Facility | | $34.67 | $1,698.24 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $4,677.35 / $10,000.00
| Facility | | $851.14 | $4,677.35 | $10,000.00 |