- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $517.78 / $517.78 / $2,247.00
| Facility | | $517.78 | $517.78 | $2,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,703.87 / $1,703.87 / $2,142.48
| Facility | | $1,703.87 | $1,703.87 | $2,142.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,687.00 / $1,687.00 / $1,687.00
| Facility | | $1,687.00 | $1,687.00 | $1,687.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,144.00 / $1,144.00 / $5,000.00
| Facility | | $1,144.00 | $1,144.00 | $5,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,144.00 / $1,144.00 / $1,196.00
| Facility | | $1,144.00 | $1,144.00 | $1,196.00 |