- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $818.00 / $2,832.00 / $7,365.00
| Facility | | $818.00 | $2,832.00 | $7,365.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,114.00 / $4,050.00 / $9,663.00
| Facility | | $2,114.00 | $4,050.00 | $9,663.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,652.00 / $1,652.00 / $1,652.00
| Facility | | $1,652.00 | $1,652.00 | $1,652.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.25 / $436.31 / $1,106.26
| Facility | | $90.25 | $436.31 | $1,106.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $2,332.00 / $3,071.00
| Facility | | $1,300.00 | $2,332.00 | $3,071.00 |