- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $205.94 / $1,386.00 / $7,212.00
| Facility | | $205.94 | $1,386.00 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,943.00 / $5,117.00 / $8,240.00
| Facility | | $1,943.00 | $5,117.00 | $8,240.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $193.83 / $247.04 / $745.50
| Facility | | $193.83 | $247.04 | $745.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $357.00 / $761.00 / $848.27
| Facility | | $357.00 | $761.00 | $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 |