- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $678.00 / $2,498.00 / $5,858.00
| Facility | | $678.00 | $2,498.00 | $5,858.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,685.25 / $9,663.12 / $13,753.10
| Facility | | $5,685.25 | $9,663.12 | $13,753.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $528.16 / $6,367.31 / $6,367.31
| Facility | | $528.16 | $6,367.31 | $6,367.31 |
- 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 |