- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $556.82 / $2,145.78 / $7,838.38
| Facility | | $556.82 | $2,145.78 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,045.38 / $2,576.14 / $4,201.35
| Facility | | $1,045.38 | $2,576.14 | $4,201.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $161.57 / $161.57 / $596.36
| Facility | | $161.57 | $161.57 | $596.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.13 / $248.15 / $609.38
| Facility | | $90.13 | $248.15 | $609.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $755.00 / $3,085.00 / $5,060.00
| Facility | | $755.00 | $3,085.00 | $5,060.00 |