- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $756.00 / $2,418.00 / $4,509.00
| Facility | | $756.00 | $2,418.00 | $4,509.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,429.16 / $12,538.59 / $27,360.92
| Facility | | $6,429.16 | $12,538.59 | $27,360.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,198.38 / $14,744.58 / $14,744.58
| Facility | | $1,198.38 | $14,744.58 | $14,744.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $1,350.00 / $1,350.00
| Facility | | $1,350.00 | $1,350.00 | $1,350.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $5,780.00 / $13,506.00
| Facility | | $1,200.00 | $5,780.00 | $13,506.00 |