- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $5,888.44 / $9,772.37
| Facility | | $239.88 | $5,888.44 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $4,897.79 / $9,549.93
| Facility | | $1,995.26 | $4,897.79 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,000.00 / $1,288.25
| Facility | | $501.19 | $1,000.00 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $194.98 / $295.12 / $489.78
| Facility | | $194.98 | $295.12 | $489.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $6,760.83 / $10,000.00
| Facility | | $1,698.24 | $6,760.83 | $10,000.00 |