- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $651.00 / $1,020.00 / $1,245.00
| Facility | | $651.00 | $1,020.00 | $1,245.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $256.10 / $526.00 / $1,437.11
| Facility | | $256.10 | $526.00 | $1,437.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,325.00 / $2,905.00
| Facility | | $1,000.00 | $1,325.00 | $2,905.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,270.29 / $1,270.29 / $6,161.06
| Facility | | $1,270.29 | $1,270.29 | $6,161.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $810.00 / $810.00 / $810.00
| Facility | | $810.00 | $810.00 | $810.00 |