- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,244.44 / $2,706.85 / $7,602.00
| Facility | | $1,244.44 | $2,706.85 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,132.00 / $3,728.00 / $6,090.00
| Facility | | $2,132.00 | $3,728.00 | $6,090.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $9,587.28 / $9,836.64
| Facility | | $55.00 | $9,587.28 | $9,836.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,794.00 / $3,626.00 / $6,291.00
| Facility | | $1,794.00 | $3,626.00 | $6,291.00 |