- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.16 / $157.16 / $2,168.00
| Facility | | $157.16 | $157.16 | $2,168.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $339.37 / $1,918.16 / $4,193.72
| Facility | | $339.37 | $1,918.16 | $4,193.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $367.34 / $573.33 / $1,379.22
| Facility | | $367.34 | $573.33 | $1,379.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.33 / $523.20 / $1,086.00
| Facility | | $318.33 | $523.20 | $1,086.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.65 / $321.54 / $655.71
| Facility | | $176.65 | $321.54 | $655.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.00 / $3,307.00 / $6,275.00
| Facility | | $1,224.00 | $3,307.00 | $6,275.00 |