- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,150.00 / $4,500.00 / $12,600.00
| Facility | | $1,150.00 | $4,500.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,873.50 / $12,508.22 / $19,762.84
| Facility | | $7,873.50 | $12,508.22 | $19,762.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,659.86 / $5,659.86 / $5,659.86
| Facility | | $5,659.86 | $5,659.86 | $5,659.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $720.54 / $1,047.66 / $14,063.00
| Facility | | $720.54 | $1,047.66 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $6,980.00 / $14,139.00
| Facility | | $1,851.00 | $6,980.00 | $14,139.00 |