- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $195.11 / $787.00 / $5,320.00
| Facility | | $195.11 | $787.00 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,014.00 / $8,584.00 / $11,253.00
| Facility | | $4,014.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $209.36 / $313.12 / $391.41
| Facility | | $209.36 | $313.12 | $391.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $192.12 / $273.72 / $273.72
| Facility | | $192.12 | $273.72 | $273.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $1,450.00 / $5,301.00
| Facility | | $523.00 | $1,450.00 | $5,301.00 |