- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $638.38 / $1,020.00 / $8,413.00
| Facility | | $638.38 | $1,020.00 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $638.38 / $804.66 / $1,278.91
| Facility | | $638.38 | $804.66 | $1,278.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,733.00 / $6,543.00
| Facility | | $900.00 | $3,733.00 | $6,543.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,389.04 / $8,957.00 / $26,542.00
| Facility | | $2,389.04 | $8,957.00 | $26,542.00 |