- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.81 / $4,164.99 / $9,727.00
| Facility | | $151.81 | $4,164.99 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,265.66 / $2,795.31 / $4,709.47
| Facility | | $1,265.66 | $2,795.31 | $4,709.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.92 / $570.00 / $1,438.20
| Facility | | $124.92 | $570.00 | $1,438.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.43 / $147.55 / $209.40
| Facility | | $116.43 | $147.55 | $209.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $6,607.00 / $8,667.00
| Facility | | $659.00 | $6,607.00 | $8,667.00 |