- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,025.38 / $1,623.60 / $12,615.00
| Facility | | $1,025.38 | $1,623.60 | $12,615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $606.10
| Facility | | $606.10 | $606.10 | $606.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,025.38 / $1,268.46 / $1,997.88
| Facility | | $1,025.38 | $1,268.46 | $1,997.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,545.00 / $22,780.00
| Facility | | $4,015.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $13,256.87 / $13,256.87
| Facility | | $55.00 | $13,256.87 | $13,256.87 |