- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.70 / $1,020.00 / $8,413.00
| Facility | | $446.70 | $1,020.00 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $1,587.44
| Facility | | $606.10 | $606.10 | $1,587.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.70 / $587.95 / $890.55
| Facility | | $446.70 | $587.95 | $890.55 |
- 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
- $1,719.52 / $5,246.20 / $26,542.00
| Facility | | $1,719.52 | $5,246.20 | $26,542.00 |