- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.58 / $398.46 / $7,212.00
| Facility | | $208.58 | $398.46 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,234.00 / $5,126.00 / $8,388.00
| Facility | | $2,234.00 | $5,126.00 | $8,388.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.25 / $210.61 / $415.83
| Facility | | $165.25 | $210.61 | $415.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $847.52 / $847.52 / $847.52
| Facility | | $847.52 | $847.52 | $847.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,638.00 / $2,854.00 / $4,271.00
| Facility | | $1,638.00 | $2,854.00 | $4,271.00 |