- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,275.00 / $5,436.00 / $8,076.00
| Facility | | $1,275.00 | $5,436.00 | $8,076.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,375.00 / $3,493.00 / $7,723.00
| Facility | | $1,375.00 | $3,493.00 | $7,723.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $310.00 / $2,529.00 / $8,118.00
| Facility | | $310.00 | $2,529.00 | $8,118.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,396.14 / $2,465.00 / $7,499.00
| Facility | | $1,396.14 | $2,465.00 | $7,499.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $462.51 / $1,126.68 / $2,488.56
| Facility | | $462.51 | $1,126.68 | $2,488.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $310.00 / $2,660.74 / $5,381.00
| Facility | | $310.00 | $2,660.74 | $5,381.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $386.00 / $1,035.00 / $2,472.00
| Facility | | $386.00 | $1,035.00 | $2,472.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,067.00 / $1,713.86 / $2,652.37
| Facility | | $1,067.00 | $1,713.86 | $2,652.37 |