- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,150.00 / $3,909.00 / $12,600.00
| Facility | | $1,150.00 | $3,909.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,954.18 / $11,047.74 / $17,455.31
| Facility | | $6,954.18 | $11,047.74 | $17,455.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,558.47 / $7,558.47 / $7,558.47
| Facility | | $7,558.47 | $7,558.47 | $7,558.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $567.54 / $863.54 / $8,986.49
| Facility | | $567.54 | $863.54 | $8,986.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.00 / $5,910.00 / $9,232.95
| Facility | | $1,481.00 | $5,910.00 | $9,232.95 |