- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $533.21 / $2,318.00 / $11,093.00
| Facility | | $533.21 | $2,318.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.00 / $5,948.00 / $9,462.00
| Facility | | $2,754.00 | $5,948.00 | $9,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $517.40 / $692.67 / $1,047.74
| Facility | | $517.40 | $692.67 | $1,047.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.00 / $634.54 / $1,627.38
| Facility | | $450.00 | $634.54 | $1,627.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,399.00 / $5,995.00 / $10,413.00
| Facility | | $1,399.00 | $5,995.00 | $10,413.00 |