- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $538.75 / $1,386.00 / $7,212.00
| Facility | | $538.75 | $1,386.00 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,389.00 / $10,288.00 / $26,304.00
| Facility | | $1,389.00 | $10,288.00 | $26,304.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $507.37 / $646.65 / $746.13
| Facility | | $507.37 | $646.65 | $746.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $622.54 / $761.00 / $3,909.74
| Facility | | $622.54 | $761.00 | $3,909.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $5,995.00 / $9,243.00
| Facility | | $1,500.00 | $5,995.00 | $9,243.00 |