- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.63 / $382.96 / $2,168.00
| Facility | | $245.63 | $382.96 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,261.61 / $5,064.68 / $11,441.84
| Facility | | $1,261.61 | $5,064.68 | $11,441.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $897.70 / $1,401.07 / $3,370.47
| Facility | | $897.70 | $1,401.07 | $3,370.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $777.93 / $1,278.57 / $2,653.91
| Facility | | $777.93 | $1,278.57 | $2,653.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $315.08 / $539.35 / $1,145.57
| Facility | | $315.08 | $539.35 | $1,145.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.00 / $3,500.00 / $6,361.00
| Facility | | $1,224.00 | $3,500.00 | $6,361.00 |