- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $230.69 / $3,762.00 / $5,937.88
| Facility | | $230.69 | $3,762.00 | $5,937.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $192.61 / $887.89 / $1,675.01
| Facility | | $192.61 | $887.89 | $1,675.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.37 / $208.36 / $282.77
| Facility | | $165.37 | $208.36 | $282.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.00 / $650.00 / $4,824.00
| Facility | | $393.00 | $650.00 | $4,824.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,097.25 / $4,901.45
| Facility | | $55.00 | $1,097.25 | $4,901.45 |