- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115.93 / $260.52 / $2,525.00
| Facility | | $115.93 | $260.52 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $590.05 / $2,868.68 / $6,480.74
| Facility | | $590.05 | $2,868.68 | $6,480.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $649.04 / $920.91 / $2,215.37
| Facility | | $649.04 | $920.91 | $2,215.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $511.33 / $841.93 / $1,744.39
| Facility | | $511.33 | $841.93 | $1,744.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.33 / $304.79 / $797.37
| Facility | | $144.33 | $304.79 | $797.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,296.00 / $3,500.00 / $6,361.00
| Facility | | $2,296.00 | $3,500.00 | $6,361.00 |