- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.48 / $1,245.00 / $7,278.00
| Facility | | $185.48 | $1,245.00 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $1,587.44
| Facility | | $530.04 | $530.04 | $1,587.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.48 / $241.47 / $391.36
| Facility | | $185.48 | $241.47 | $391.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,110.11 / $5,246.20 / $16,394.00
| Facility | | $1,110.11 | $5,246.20 | $16,394.00 |