- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $1,548.82 / $4,168.69
| Facility | | $645.65 | $1,548.82 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.02 / $2,691.53 / $6,456.54
| Facility | | $0.02 | $2,691.53 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39.81 / $100.00 / $100.00
| Facility | | $39.81 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $199.53 / $812.83 / $2,398.83
| Facility | | $199.53 | $812.83 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $501.19 / $1,230.27
| Facility | | $177.83 | $501.19 | $1,230.27 |