- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.77 / $540.76 / $6,781.00
| Facility | | $263.77 | $540.76 | $6,781.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,210.52 / $6,357.94 / $12,605.63
| Facility | | $3,210.52 | $6,357.94 | $12,605.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $859.95 / $1,219.52 / $2,933.72
| Facility | | $859.95 | $1,219.52 | $2,933.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.08 / $1,114.93 / $2,310.01
| Facility | | $699.08 | $1,114.93 | $2,310.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $382.50 / $772.62 / $4,974.00
| Facility | | $382.50 | $772.62 | $4,974.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,735.00 / $4,974.00 / $8,812.00
| Facility | | $2,735.00 | $4,974.00 | $8,812.00 |