- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $4,474.00 / $8,239.00
| Facility | | $1,965.00 | $4,474.00 | $8,239.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.45 / $3,106.86 / $5,113.62
| Facility | | $830.45 | $3,106.86 | $5,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,214.21 / $2,214.21 / $2,214.21
| Facility | | $2,214.21 | $2,214.21 | $2,214.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $439.97 / $681.08 / $3,787.00
| Facility | | $439.97 | $681.08 | $3,787.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,343.00 / $3,339.00 / $5,838.00
| Facility | | $2,343.00 | $3,339.00 | $5,838.00 |