- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.85 / $2,650.70 / $7,212.00
| Facility | | $139.85 | $2,650.70 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,943.00 / $5,117.00 / $8,240.00
| Facility | | $1,943.00 | $5,117.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.51 / $167.61 / $193.40
| Facility | | $131.51 | $167.61 | $193.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.56 / $538.00 / $1,158.10
| Facility | | $161.56 | $538.00 | $1,158.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,817.00 / $5,402.00
| Facility | | $900.00 | $3,817.00 | $5,402.00 |