- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $545.04 / $545.04 / $2,525.00
| Facility | | $545.04 | $545.04 | $2,525.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $795.94 / $4,844.72 / $10,098.06
| Facility | | $795.94 | $4,844.72 | $10,098.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,325.88 / $1,881.24 / $4,525.57
| Facility | | $1,325.88 | $1,881.24 | $4,525.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,205.34 / $1,719.90 / $3,563.44
| Facility | | $1,205.34 | $1,719.90 | $3,563.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.00 / $934.85 / $2,523.00
| Facility | | $555.00 | $934.85 | $2,523.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,388.00 / $3,500.00 / $6,361.00
| Facility | | $1,388.00 | $3,500.00 | $6,361.00 |