- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $1,715.06 / $8,229.00
| Facility | | $860.00 | $1,715.06 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,755.00 / $8,584.00 / $11,253.00
| Facility | | $4,755.00 | $8,584.00 | $11,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,657.69 / $2,275.27 / $2,624.68
| Facility | | $1,657.69 | $2,275.27 | $2,624.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,585.74 / $2,006.27 / $2,006.27
| Facility | | $1,585.74 | $2,006.27 | $2,006.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $599.00 / $4,298.00 / $30,001.00
| Facility | | $599.00 | $4,298.00 | $30,001.00 |