- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.00 / $2,901.00 / $6,483.00
| Facility | | $1,070.00 | $2,901.00 | $6,483.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.79 / $2,064.02 / $3,616.69
| Facility | | $552.79 | $2,064.02 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.54 / $139.57 / $446.00
| Facility | | $105.54 | $139.57 | $446.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.49 / $323.52 / $619.54
| Facility | | $213.49 | $323.52 | $619.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.00 / $1,488.00 / $2,057.00
| Facility | | $285.00 | $1,488.00 | $2,057.00 |