- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $3,532.00 / $7,746.60
| Facility | | $900.00 | $3,532.00 | $7,746.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,057.00 / $9,135.51 / $16,947.12
| Facility | | $3,057.00 | $9,135.51 | $16,947.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,960.00 / $4,290.00 / $4,290.00
| Facility | | $2,960.00 | $4,290.00 | $4,290.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,896.28 / $7,163.00 / $11,274.34
| Facility | | $5,896.28 | $7,163.00 | $11,274.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,800.00 / $3,361.00 / $6,361.00
| Facility | | $1,800.00 | $3,361.00 | $6,361.00 |