- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.00 / $1,524.00 / $3,728.00
| Facility | | $593.00 | $1,524.00 | $3,728.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,140.92 / $5,301.99 / $10,545.78
| Facility | | $2,140.92 | $5,301.99 | $10,545.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $447.46 / $1,342.02
| Facility | | $40.00 | $447.46 | $1,342.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.52 / $650.00 / $1,932.08
| Facility | | $586.52 | $650.00 | $1,932.08 |
- 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 |