- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.00 / $1,520.00 / $3,685.00
| Facility | | $593.00 | $1,520.00 | $3,685.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,753.58 / $4,550.27 / $6,981.81
| Facility | | $1,753.58 | $4,550.27 | $6,981.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.41 / $2,596.76 / $2,596.76
| Facility | | $578.41 | $2,596.76 | $2,596.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.00 / $679.62 / $1,936.96
| Facility | | $615.00 | $679.62 | $1,936.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $3,238.00 / $8,488.00
| Facility | | $882.00 | $3,238.00 | $8,488.00 |