- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.00 / $2,678.00 / $6,681.00
| Facility | | $1,230.00 | $2,678.00 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,703.00 / $3,485.00 / $5,878.00
| Facility | | $1,703.00 | $3,485.00 | $5,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.00 / $1,759.11 / $2,530.00
| Facility | | $525.00 | $1,759.11 | $2,530.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,060.28 / $7,929.30 / $26,542.00
| Facility | | $5,060.28 | $7,929.30 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,280.00 / $4,021.00 / $7,669.00
| Facility | | $1,280.00 | $4,021.00 | $7,669.00 |