- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.15 / $903.00 / $5,449.00
| Facility | | $225.15 | $903.00 | $5,449.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.41 / $650.35 / $1,226.89
| Facility | | $338.41 | $650.35 | $1,226.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.15 / $595.32 / $926.20
| Facility | | $225.15 | $595.32 | $926.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $393.00 / $650.00 / $4,824.00
| Facility | | $393.00 | $650.00 | $4,824.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,290.34 / $1,290.34 / $12,000.00
| Facility | | $1,290.34 | $1,290.34 | $12,000.00 |