- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $319.45 / $2,133.00 / $6,681.00
| Facility | | $319.45 | $2,133.00 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.00 / $148.00 / $1,917.00
| Facility | | $101.00 | $148.00 | $1,917.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.12 / $605.00 / $2,530.00
| Facility | | $134.12 | $605.00 | $2,530.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $4,262.50 / $4,262.50
| Facility | | $55.00 | $4,262.50 | $4,262.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $875.00 / $2,260.00 / $4,330.00
| Facility | | $875.00 | $2,260.00 | $4,330.00 |