- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.89 / $1,338.00 / $8,413.00
| Facility | | $227.89 | $1,338.00 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.36 / $2,446.52 / $4,615.34
| Facility | | $495.36 | $2,446.52 | $4,615.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.89 / $410.14 / $512.75
| Facility | | $227.89 | $410.14 | $512.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $773.00 / $1,208.00 / $9,324.00
| Facility | | $773.00 | $1,208.00 | $9,324.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,263.83 / $13,505.55 / $26,542.00
| Facility | | $1,263.83 | $13,505.55 | $26,542.00 |