- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,150.00 / $3,803.00 / $12,600.00
| Facility | | $1,150.00 | $3,803.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,587.26 / $8,738.79 / $13,706.31
| Facility | | $5,587.26 | $8,738.79 | $13,706.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,545.78 / $2,545.78 / $2,545.78
| Facility | | $2,545.78 | $2,545.78 | $2,545.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.47 / $809.61 / $6,840.79
| Facility | | $562.47 | $809.61 | $6,840.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,157.00 / $4,612.45 / $8,114.35
| Facility | | $1,157.00 | $4,612.45 | $8,114.35 |