- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,187.76 / $3,801.89
| Facility | | $575.44 | $2,187.76 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $954.99 / $2,818.38
| Facility | | $56.23 | $954.99 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70.79 / $70.79 / $165.96
| Facility | | $70.79 | $70.79 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $112.20 / $8,511.38
| Facility | | $56.23 | $112.20 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,467.37
| Facility | | $630.96 | $2,041.74 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $1,000.00 / $2,818.38
| Facility | | $56.23 | $1,000.00 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,862.09 / $2,818.38
| Facility | | $630.96 | $1,862.09 | $2,818.38 |