- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.04 / $5,000.27 / $7,838.38
| Facility | | $141.04 | $5,000.27 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,835.94 / $6,357.37 / $9,865.12
| Facility | | $1,835.94 | $6,357.37 | $9,865.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,300.00 / $1,300.00 / $1,300.00
| Facility | | $1,300.00 | $1,300.00 | $1,300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $180.64 / $231.20 / $1,300.00
| Facility | | $180.64 | $231.20 | $1,300.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $639.00 / $5,971.00 / $8,422.00
| Facility | | $639.00 | $5,971.00 | $8,422.00 |