- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $497.70 / $2,423.41 / $5,449.00
| Facility | | $497.70 | $2,423.41 | $5,449.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $395.75 / $395.75 / $1,587.44
| Facility | | $395.75 | $395.75 | $1,587.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $497.70 / $581.10 / $904.77
| Facility | | $497.70 | $581.10 | $904.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,937.04 / $5,246.20 / $12,000.00
| Facility | | $1,937.04 | $5,246.20 | $12,000.00 |