- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $593.00 / $1,520.00 / $3,685.00
| Facility | | $593.00 | $1,520.00 | $3,685.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,516.71 / $7,447.78 / $11,342.45
| Facility | | $3,516.71 | $7,447.78 | $11,342.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $627.92 / $2,752.77
| Facility | | $40.00 | $627.92 | $2,752.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.00 / $720.00 / $3,963.12
| Facility | | $615.00 | $720.00 | $3,963.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $3,238.00 / $8,488.00
| Facility | | $882.00 | $3,238.00 | $8,488.00 |