- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,582.00 / $2,933.00 / $6,483.00
| Facility | | $1,582.00 | $2,933.00 | $6,483.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $587.35 / $2,283.06 / $3,616.69
| Facility | | $587.35 | $2,283.06 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $250.00 / $250.00 / $607.00
| Facility | | $250.00 | $250.00 | $607.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103.58 / $166.19 / $2,674.00
| Facility | | $103.58 | $166.19 | $2,674.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $968.00 / $1,958.00 / $3,268.00
| Facility | | $968.00 | $1,958.00 | $3,268.00 |