- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,821.00 / $2,940.00 / $7,602.00
| Facility | | $1,821.00 | $2,940.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,112.00 / $2,302.00 / $4,147.00
| Facility | | $1,112.00 | $2,302.00 | $4,147.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $525.00 / $2,277.00
| Facility | | $500.00 | $525.00 | $2,277.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $13,035.36 / $13,347.28
| Facility | | $55.00 | $13,035.36 | $13,347.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $875.00 / $2,397.00 / $4,544.00
| Facility | | $875.00 | $2,397.00 | $4,544.00 |