- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,222.25 / $4,376.00 / $12,600.00
| Facility | | $1,222.25 | $4,376.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,411.10 / $3,551.35 / $5,952.49
| Facility | | $2,411.10 | $3,551.35 | $5,952.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $505.00 / $505.00
| Facility | | $505.00 | $505.00 | $505.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $781.61 / $1,229.39 / $11,209.00
| Facility | | $781.61 | $1,229.39 | $11,209.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,967.00 / $4,960.00 / $11,732.00
| Facility | | $1,967.00 | $4,960.00 | $11,732.00 |