- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $763.00 / $2,562.00 / $14,161.53
| Facility | | $763.00 | $2,562.00 | $14,161.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,898.80 / $10,352.46 / $14,300.59
| Facility | | $5,898.80 | $10,352.46 | $14,300.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $867.95 / $7,943.58 / $7,943.58
| Facility | | $867.95 | $7,943.58 | $7,943.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $1,200.00 / $1,200.00
| Facility | | $1,200.00 | $1,200.00 | $1,200.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,305.00 / $7,100.00 / $22,240.00
| Facility | | $1,305.00 | $7,100.00 | $22,240.00 |