- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $787.00 / $1,188.32 / $2,747.00
| Facility | | $787.00 | $1,188.32 | $2,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,643.00 / $3,498.00 / $8,517.00
| Facility | | $1,643.00 | $3,498.00 | $8,517.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,042.13 / $1,512.41 / $1,744.68
| Facility | | $1,042.13 | $1,512.41 | $1,744.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,324.34 / $1,324.34 / $1,324.34
| Facility | | $1,324.34 | $1,324.34 | $1,324.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $2,723.00 / $6,295.00
| Facility | | $599.00 | $2,723.00 | $6,295.00 |