- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $756.00 / $2,397.00 / $5,203.00
| Facility | | $756.00 | $2,397.00 | $5,203.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,429.16 / $12,538.59 / $27,360.92
| Facility | | $6,429.16 | $12,538.59 | $27,360.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $802.24 / $9,848.85 / $9,848.85
| Facility | | $802.24 | $9,848.85 | $9,848.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $1,350.00 / $1,350.00
| Facility | | $1,350.00 | $1,350.00 | $1,350.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,305.00 / $7,450.00 / $24,532.00
| Facility | | $1,305.00 | $7,450.00 | $24,532.00 |