- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,821.00 / $3,940.00 / $7,602.00
| Facility | | $1,821.00 | $3,940.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,695.00 / $5,467.00 / $9,283.00
| Facility | | $2,695.00 | $5,467.00 | $9,283.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $30,593.61 / $31,255.56
| Facility | | $2,000.00 | $30,593.61 | $31,255.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,964.00 / $8,273.00 / $12,407.00
| Facility | | $3,964.00 | $8,273.00 | $12,407.00 |