- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.33 / $102.33 / $2,238.72
| Facility | | $102.33 | $102.33 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83.18 / $281.84 / $446.68
| Facility | | $83.18 | $281.84 | $446.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.47 / $389.05 / $933.25
| Facility | | $245.47 | $389.05 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $416.87 / $741.31
| Facility | | $302.00 | $416.87 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.20 / $177.83 / $363.08
| Facility | | $112.20 | $177.83 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $2,691.53 / $6,456.54
| Facility | | $1,445.44 | $2,691.53 | $6,456.54 |