- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.00 / $2,747.00 / $7,542.00
| Facility | | $803.00 | $2,747.00 | $7,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,626.73 / $4,721.85 / $9,381.18
| Facility | | $2,626.73 | $4,721.85 | $9,381.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $949.52 / $949.52 / $993.59
| Facility | | $949.52 | $949.52 | $993.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,953.70 / $1,953.70 / $2,017.56
| Facility | | $1,953.70 | $1,953.70 | $2,017.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,001.70 / $16,394.00 / $16,394.00
| Facility | | $9,001.70 | $16,394.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $955.24 / $1,222.29 / $1,791.63
| Facility | | $955.24 | $1,222.29 | $1,791.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $955.24 / $1,224.30 / $2,017.56
| Facility | | $955.24 | $1,224.30 | $2,017.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,634.00 / $4,200.00 / $10,600.00
| Facility | | $1,634.00 | $4,200.00 | $10,600.00 |