- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.80 / $3,776.00 / $9,727.00
| Facility | | $97.80 | $3,776.00 | $9,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $484.49 / $1,030.48 / $1,746.34
| Facility | | $484.49 | $1,030.48 | $1,746.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $140.58 / $607.82
| Facility | | $100.00 | $140.58 | $607.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $97.80 / $216.44 / $364.50
| Facility | | $97.80 | $216.44 | $364.50 |
- Facility/Professional
- Facility
- Modifier
- 50
- Low / Median / High Price
- $221.83 / $324.66 / $538.82
| Facility | 50 | $221.83 | $324.66 | $538.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.00 / $3,866.00 / $6,584.00
| Facility | | $490.00 | $3,866.00 | $6,584.00 |