- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.00 / $2,736.07 / $6,483.00
| Facility | | $1,070.00 | $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
- $446.00 / $2,109.10 / $3,455.73
| Facility | | $446.00 | $2,109.10 | $3,455.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.58 / $412.38 / $3,008.00
| Facility | | $316.58 | $412.38 | $3,008.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $845.00 / $3,311.00 / $5,133.00
| Facility | | $845.00 | $3,311.00 | $5,133.00 |