- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.33 / $327.33 / $2,505.00
| Facility | | $327.33 | $327.33 | $2,505.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.11 / $792.68 / $2,484.00
| Facility | | $316.11 | $792.68 | $2,484.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $754.67 / $1,070.21 / $2,574.54
| Facility | | $754.67 | $1,070.21 | $2,574.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $613.49 / $978.43 / $2,027.20
| Facility | | $613.49 | $978.43 | $2,027.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $269.48 / $540.64 / $1,727.00
| Facility | | $269.48 | $540.64 | $1,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.00 / $1,749.00 / $2,883.00
| Facility | | $563.00 | $1,749.00 | $2,883.00 |