- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.45 / $637.00 / $8,229.00
| Facility | | $257.45 | $637.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,421.00 / $2,565.00 / $4,650.00
| Facility | | $1,421.00 | $2,565.00 | $4,650.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.36 / $345.00 / $397.99
| Facility | | $251.36 | $345.00 | $397.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $303.25 / $303.25 / $303.25
| Facility | | $303.25 | $303.25 | $303.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $794.00 / $5,301.00
| Facility | | $523.00 | $794.00 | $5,301.00 |