- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.64 / $1,773.00 / $7,356.26
| Facility | | $295.64 | $1,773.00 | $7,356.26 |
- 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
- $275.30 / $357.89 / $412.95
| Facility | | $275.30 | $357.89 | $412.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.71 / $402.00 / $1,873.52
| Facility | | $343.71 | $402.00 | $1,873.52 |
- 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 |