- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $166.90 / $436.85 / $5,634.00
| Facility | | $166.90 | $436.85 | $5,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,636.00 / $3,840.00 / $7,036.00
| Facility | | $1,636.00 | $3,840.00 | $7,036.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.78 / $199.91 / $505.21
| Facility | | $153.78 | $199.91 | $505.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $289.20 / $402.00 / $848.27
| Facility | | $289.20 | $402.00 | $848.27 |
- 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 |