- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.50 / $860.00 / $8,229.00
| Facility | | $109.50 | $860.00 | $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
- $106.93 / $146.78 / $169.31
| Facility | | $106.93 | $146.78 | $169.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.11 / $129.11 / $129.11
| Facility | | $129.11 | $129.11 | $129.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $523.00 / $794.00 / $5,301.00
| Facility | | $523.00 | $794.00 | $5,301.00 |