- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.00 / $2,640.00 / $5,506.00
| Facility | | $1,070.00 | $2,640.00 | $5,506.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $412.80 / $1,541.29 / $2,700.74
| Facility | | $412.80 | $1,541.29 | $2,700.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $333.00 / $1,571.83 / $2,575.42
| Facility | | $333.00 | $1,571.83 | $2,575.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.60 / $574.25 / $1,186.57
| Facility | | $345.60 | $574.25 | $1,186.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $845.00 / $3,311.00 / $5,133.00
| Facility | | $845.00 | $3,311.00 | $5,133.00 |