- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $183.04 / $183.04 / $5,753.00
| Facility | | $183.04 | $183.04 | $5,753.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,733.81 / $3,491.38 / $6,762.24
| Facility | | $1,733.81 | $3,491.38 | $6,762.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $430.86 / $672.47 / $1,617.71
| Facility | | $430.86 | $672.47 | $1,617.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.38 / $613.66 / $1,273.79
| Facility | | $373.38 | $613.66 | $1,273.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $204.68 / $364.48 / $650.33
| Facility | | $204.68 | $364.48 | $650.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.00 / $3,500.00 / $6,361.00
| Facility | | $1,224.00 | $3,500.00 | $6,361.00 |