- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $841.00 / $2,418.00 / $5,150.00
| Facility | | $841.00 | $2,418.00 | $5,150.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,264.95 / $7,426.06 / $14,166.86
| Facility | | $4,264.95 | $7,426.06 | $14,166.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $722.84 / $3,731.16 / $3,731.16
| Facility | | $722.84 | $3,731.16 | $3,731.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,400.00 / $1,400.00 / $1,400.00
| Facility | | $1,400.00 | $1,400.00 | $1,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,150.00 / $5,780.00 / $13,506.00
| Facility | | $1,150.00 | $5,780.00 | $13,506.00 |