- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $238.35 / $4,286.10 / $11,627.00
| Facility | | $238.35 | $4,286.10 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.85 / $1,163.83 / $2,389.00
| Facility | | $562.85 | $1,163.83 | $2,389.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.39 / $383.54 / $383.54
| Facility | | $263.39 | $383.54 | $383.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,840.00 / $5,513.00 / $7,847.00
| Facility | | $2,840.00 | $5,513.00 | $7,847.00 |