- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $468.03 / $1,230.00 / $3,500.00
| Facility | | $468.03 | $1,230.00 | $3,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,375.94 / $4,681.72 / $11,151.85
| Facility | | $1,375.94 | $4,681.72 | $11,151.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $316.41 / $2,807.66
| Facility | | $40.00 | $316.41 | $2,807.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.00 / $535.00 / $4,042.13
| Facility | | $488.00 | $535.00 | $4,042.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $746.00 / $2,415.00 / $6,661.00
| Facility | | $746.00 | $2,415.00 | $6,661.00 |