- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $3,745.00 / $7,467.00
| Facility | | $1,965.00 | $3,745.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,787.48 / $4,193.09
| Facility | | $672.35 | $2,787.48 | $4,193.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,645.45 / $4,645.45 / $4,645.45
| Facility | | $4,645.45 | $4,645.45 | $4,645.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $427.91 / $627.19 / $3,790.00
| Facility | | $427.91 | $627.19 | $3,790.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,343.00 / $3,339.00 / $5,838.00
| Facility | | $2,343.00 | $3,339.00 | $5,838.00 |