- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $5,100.00 / $14,431.00
| Facility | | $789.00 | $5,100.00 | $14,431.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,414.66 / $10,782.75 / $18,394.90
| Facility | | $8,414.66 | $10,782.75 | $18,394.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $11,535.97 / $17,808.53
| Facility | | $2,089.36 | $11,535.97 | $17,808.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,514.75 / $14,484.94 / $19,614.00
| Facility | | $9,514.75 | $14,484.94 | $19,614.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,348.35 / $15,678.45 / $23,001.34
| Facility | | $10,348.35 | $15,678.45 | $23,001.34 |