- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.54 / $1,662.00 / $9,062.00
| Facility | | $193.54 | $1,662.00 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $603.46 / $1,488.93 / $3,438.91
| Facility | | $603.46 | $1,488.93 | $3,438.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $585.00 / $1,139.16
| Facility | | $375.00 | $585.00 | $1,139.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.54 / $322.13 / $982.99
| Facility | | $193.54 | $322.13 | $982.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.00 / $6,172.00 / $8,667.00
| Facility | | $586.00 | $6,172.00 | $8,667.00 |