- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,188.08 / $9,062.00 / $18,276.00
| Facility | | $2,188.08 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,339.30 / $9,031.54 / $15,459.94
| Facility | | $4,339.30 | $9,031.54 | $15,459.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.00 / $815.00 / $2,594.85
| Facility | | $815.00 | $815.00 | $2,594.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,464.00 / $1,959.45 / $2,953.91
| Facility | | $1,464.00 | $1,959.45 | $2,953.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $13,190.00 / $19,665.00
| Facility | | $2,155.00 | $13,190.00 | $19,665.00 |