- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $497.00 / $1,236.00 / $3,500.00
| Facility | | $497.00 | $1,236.00 | $3,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,714.38 / $4,081.90 / $6,007.08
| Facility | | $1,714.38 | $4,081.90 | $6,007.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40.00 / $327.68 / $1,342.02
| Facility | | $40.00 | $327.68 | $1,342.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.00 / $535.00 / $1,932.08
| Facility | | $488.00 | $535.00 | $1,932.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $470.00 / $1,429.00 / $4,010.00
| Facility | | $470.00 | $1,429.00 | $4,010.00 |