- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.98 / $1,231.68 / $4,598.70
| Facility | | $342.98 | $1,231.68 | $4,598.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,830.00 / $8,584.00 / $11,253.00
| Facility | | $5,830.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $318.04 / $436.52 / $503.56
| Facility | | $318.04 | $436.52 | $503.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $573.71 / $573.71 / $573.71
| Facility | | $573.71 | $573.71 | $573.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $739.00 / $3,828.00 / $8,582.00
| Facility | | $739.00 | $3,828.00 | $8,582.00 |