- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $288.79 / $787.00 / $8,229.00
| Facility | | $288.79 | $787.00 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.00 / $2,067.00 / $2,978.00
| Facility | | $1,041.00 | $2,067.00 | $2,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $284.63 / $390.67 / $450.66
| Facility | | $284.63 | $390.67 | $450.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.71 / $343.71 / $343.71
| Facility | | $343.71 | $343.71 | $343.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $794.00 / $5,301.00
| Facility | | $523.00 | $794.00 | $5,301.00 |