- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.60 / $319.60 / $2,168.00
| Facility | | $319.60 | $319.60 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,397.98 / $2,798.21 / $5,638.17
| Facility | | $1,397.98 | $2,798.21 | $5,638.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $740.35 / $1,049.91 / $2,525.69
| Facility | | $740.35 | $1,049.91 | $2,525.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.85 / $959.87 / $1,988.74
| Facility | | $601.85 | $959.87 | $1,988.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.60 / $548.98 / $4,013.00
| Facility | | $319.60 | $548.98 | $4,013.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,296.00 / $3,500.00 / $6,361.00
| Facility | | $2,296.00 | $3,500.00 | $6,361.00 |