- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.29 / $543.65 / $5,449.00
| Facility | | $149.29 | $543.65 | $5,449.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.43 / $257.43 / $257.43
| Facility | | $257.43 | $257.43 | $257.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $163.41 / $453.48 / $1,000.00
| Facility | | $163.41 | $453.48 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.00 / $874.00 / $2,074.00
| Facility | | $116.00 | $874.00 | $2,074.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,002.54 / $1,002.54
| Facility | | $55.00 | $1,002.54 | $1,002.54 |