- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $497.00 / $1,273.00 / $3,500.00
| Facility | | $497.00 | $1,273.00 | $3,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,257.63 / $6,536.08 / $14,978.42
| Facility | | $3,257.63 | $6,536.08 | $14,978.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $401.82 / $1,247.56 / $1,247.56
| Facility | | $401.82 | $1,247.56 | $1,247.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.00 / $400.00 / $400.00
| Facility | | $400.00 | $400.00 | $400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $6,420.00 / $13,506.00
| Facility | | $1,200.00 | $6,420.00 | $13,506.00 |