- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.00 / $1,743.00 / $3,884.00
| Facility | | $612.00 | $1,743.00 | $3,884.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,488.83 / $4,395.52 / $6,555.36
| Facility | | $2,488.83 | $4,395.52 | $6,555.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $408.19 / $3,313.42 / $3,313.42
| Facility | | $408.19 | $3,313.42 | $3,313.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,802.00 / $1,802.00 / $1,802.00
| Facility | | $1,802.00 | $1,802.00 | $1,802.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $746.00 / $2,415.00 / $7,085.00
| Facility | | $746.00 | $2,415.00 | $7,085.00 |