- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,517.00 / $2,678.00 / $6,681.00
| Facility | | $1,517.00 | $2,678.00 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,678.00 / $3,485.00 / $5,878.00
| Facility | | $1,678.00 | $3,485.00 | $5,878.00 |
- 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 / $7,220.96 / $7,381.44
| Facility | | $55.00 | $7,220.96 | $7,381.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,001.00 / $3,351.00 / $6,285.00
| Facility | | $1,001.00 | $3,351.00 | $6,285.00 |