- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.70 / $678.27 / $5,320.00
| Facility | | $118.70 | $678.27 | $5,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $2,067.00 / $2,978.00
| Facility | | $1,041.00 | $2,067.00 | $2,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.43 / $161.10 / $185.84
| Facility | | $117.43 | $161.10 | $185.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $211.73 / $211.73 / $211.73
| Facility | | $211.73 | $211.73 | $211.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $1,913.00 / $5,301.00
| Facility | | $523.00 | $1,913.00 | $5,301.00 |