- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $231.66 / $4,673.00 / $9,870.00
| Facility | | $231.66 | $4,673.00 | $9,870.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $603.00 / $1,000.00 / $7,069.93
| Facility | | $603.00 | $1,000.00 | $7,069.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $615.00 / $1,139.16
| Facility | | $375.00 | $615.00 | $1,139.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.46 / $268.07 / $396.55
| Facility | | $198.46 | $268.07 | $396.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $614.00 / $5,249.00 / $9,900.00
| Facility | | $614.00 | $5,249.00 | $9,900.00 |