- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $207.25 / $207.25 / $2,693.00
| Facility | | $207.25 | $207.25 | $2,693.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.98 / $174.50 / $797.04
| Facility | | $0.98 | $174.50 | $797.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.73 / $721.44 / $1,735.52
| Facility | | $508.73 | $721.44 | $1,735.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $413.56 / $659.57 / $1,366.55
| Facility | | $413.56 | $659.57 | $1,366.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $285.11 / $422.75 / $1,966.00
| Facility | | $285.11 | $422.75 | $1,966.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.00 / $1,749.00 / $2,883.00
| Facility | | $563.00 | $1,749.00 | $2,883.00 |