- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,288.00 / $5,092.00 / $12,400.00
| Facility | | $1,288.00 | $5,092.00 | $12,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,404.75 / $4,404.75 / $4,404.75
| Facility | | $4,404.75 | $4,404.75 | $4,404.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,275.00 / $3,500.00 / $7,095.00
| Facility | | $1,275.00 | $3,500.00 | $7,095.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.00 / $1,000.00 / $10,000.00
| Facility | | $400.00 | $1,000.00 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.00 / $907.00 / $2,062.00
| Facility | | $400.00 | $907.00 | $2,062.00 |