- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.80 / $903.00 / $7,362.00
| Facility | | $263.80 | $903.00 | $7,362.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,457.61 / $1,457.61 / $1,478.88
| Facility | | $1,457.61 | $1,457.61 | $1,478.88 |
- 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
- $263.80 / $359.50 / $581.39
| Facility | | $263.80 | $359.50 | $581.39 |
- 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
- $1,008.32 / $5,246.20 / $12,000.00
| Facility | | $1,008.32 | $5,246.20 | $12,000.00 |