- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.69 / $346.69 / $6,575.00
| Facility | | $346.69 | $346.69 | $6,575.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,538.78 / $6,598.98 / $13,089.90
| Facility | | $3,538.78 | $6,598.98 | $13,089.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $846.04 / $1,200.41 / $2,887.74
| Facility | | $846.04 | $1,200.41 | $2,887.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $769.13 / $1,097.46 / $2,273.81
| Facility | | $769.13 | $1,097.46 | $2,273.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.69 / $593.15 / $2,296.00
| Facility | | $346.69 | $593.15 | $2,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,347.00 / $2,296.00 / $6,275.00
| Facility | | $1,347.00 | $2,296.00 | $6,275.00 |