- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.92 / $2,605.25 / $9,062.00
| Facility | | $331.92 | $2,605.25 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $998.26 / $1,953.98 / $3,790.27
| Facility | | $998.26 | $1,953.98 | $3,790.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.00 / $655.00 / $1,139.16
| Facility | | $375.00 | $655.00 | $1,139.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $257.07 / $388.40 / $535.66
| Facility | | $257.07 | $388.40 | $535.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $614.00 / $6,607.00 / $9,900.00
| Facility | | $614.00 | $6,607.00 | $9,900.00 |