- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,261.00 / $4,376.00 / $12,154.00
| Facility | | $1,261.00 | $4,376.00 | $12,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,597.30 / $5,765.91 / $6,527.38
| Facility | | $2,597.30 | $5,765.91 | $6,527.38 |
- 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
- $571.35 / $897.90 / $6,724.00
| Facility | | $571.35 | $897.90 | $6,724.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,269.00 / $6,407.00 / $12,224.00
| Facility | | $2,269.00 | $6,407.00 | $12,224.00 |