- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $709.00 / $2,130.32 / $6,821.72
| Facility | | $709.00 | $2,130.32 | $6,821.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $960.73 / $7,231.00
| Facility | | $627.00 | $960.73 | $7,231.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $959.30 / $1,142.47 / $1,477.68
| Facility | | $959.30 | $1,142.47 | $1,477.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,851.32 / $11,617.47 / $13,632.60
| Facility | | $4,851.32 | $11,617.47 | $13,632.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.32 / $435.71 / $6,679.00
| Facility | | $214.32 | $435.71 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,380.66 / $5,868.59 / $6,520.81
| Facility | | $3,380.66 | $5,868.59 | $6,520.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $7,561.00
| Facility | | $627.00 | $1,818.00 | $7,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.00 / $1,818.00 / $7,231.00
| Facility | | $627.00 | $1,818.00 | $7,231.00 |