- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.50 / $1,044.28 / $7,212.00
| Facility | | $142.50 | $1,044.28 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,682.00 / $3,840.00 / $7,747.00
| Facility | | $1,682.00 | $3,840.00 | $7,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.63 / $145.22 / $164.28
| Facility | | $139.63 | $145.22 | $164.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.59 / $1,061.59 / $1,061.59
| Facility | | $1,061.59 | $1,061.59 | $1,061.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,462.00 / $3,870.00 / $6,474.00
| Facility | | $2,462.00 | $3,870.00 | $6,474.00 |