- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,014.00 / $2,736.07 / $6,483.00
| Facility | | $1,014.00 | $2,736.07 | $6,483.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.79 / $2,064.02 / $3,616.69
| Facility | | $552.79 | $2,064.02 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $734.77 / $971.62 / $1,591.99
| Facility | | $734.77 | $971.62 | $1,591.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.93 / $289.07 / $2,086.00
| Facility | | $214.93 | $289.07 | $2,086.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,214.00 / $2,416.00 / $4,486.00
| Facility | | $1,214.00 | $2,416.00 | $4,486.00 |