- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $334.20 / $334.20 / $2,168.00
| Facility | | $334.20 | $334.20 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.76 / $4,376.30 / $9,046.11
| Facility | | $2,088.76 | $4,376.30 | $9,046.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.73 / $1,157.41 / $2,784.30
| Facility | | $815.73 | $1,157.41 | $2,784.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.58 / $1,058.15 / $2,192.36
| Facility | | $741.58 | $1,058.15 | $2,192.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $334.20 / $570.98 / $2,296.00
| Facility | | $334.20 | $570.98 | $2,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,388.00 / $3,500.00 / $6,361.00
| Facility | | $1,388.00 | $3,500.00 | $6,361.00 |