- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,162.00 / $2,956.00 / $5,506.00
| Facility | | $1,162.00 | $2,956.00 | $5,506.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.60 / $1,640.88 / $2,700.74
| Facility | | $438.60 | $1,640.88 | $2,700.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $695.64 / $695.64 / $695.64
| Facility | | $695.64 | $695.64 | $695.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.25 / $130.51 / $2,594.00
| Facility | | $90.25 | $130.51 | $2,594.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,068.00 / $1,711.00 / $3,268.00
| Facility | | $1,068.00 | $1,711.00 | $3,268.00 |