- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.32 / $903.00 / $7,362.00
| Facility | | $162.32 | $903.00 | $7,362.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,192.79 / $1,192.79 / $1,210.19
| Facility | | $1,192.79 | $1,192.79 | $1,210.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.75 / $395.75 / $2,710.28
| Facility | | $395.75 | $395.75 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.32 / $232.00 / $366.84
| Facility | | $162.32 | $232.00 | $366.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,733.00 / $6,543.00
| Facility | | $900.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $613.79 / $8,957.00 / $12,000.00
| Facility | | $613.79 | $8,957.00 | $12,000.00 |