- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.94 / $787.00 / $5,320.00
| Facility | | $336.94 | $787.00 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.00 / $2,316.00 / $4,389.00
| Facility | | $1,258.00 | $2,316.00 | $4,389.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $368.74 / $524.87 / $605.47
| Facility | | $368.74 | $524.87 | $605.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $465.35 / $465.35 / $561.10
| Facility | | $465.35 | $465.35 | $561.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $3,828.00 / $8,582.00
| Facility | | $739.00 | $3,828.00 | $8,582.00 |