- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.15 / $151.36 / $151.36
| Facility | | $107.15 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $4,466.84 / $10,715.19
| Facility | | $616.60 | $4,466.84 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $537.03 / $1,288.25
| Facility | | $380.19 | $537.03 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $512.86 / $1,000.00
| Facility | | $416.87 | $512.86 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $199.53 / $416.87
| Facility | | $117.49 | $199.53 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,162.28 / $6,165.95
| Facility | | $1,584.89 | $3,162.28 | $6,165.95 |