- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $941.00 / $2,758.00 / $5,432.00
| Facility | | $941.00 | $2,758.00 | $5,432.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,699.40 / $5,271.23 / $7,426.06
| Facility | | $2,699.40 | $5,271.23 | $7,426.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $40.00 / $775.10
| Facility | | $40.00 | $40.00 | $775.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,650.00 / $1,650.00 / $1,650.00
| Facility | | $1,650.00 | $1,650.00 | $1,650.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $882.00 / $3,238.00 / $9,160.00
| Facility | | $882.00 | $3,238.00 | $9,160.00 |