- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $872.16 / $2,403.40 / $6,681.00
| Facility | | $872.16 | $2,403.40 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,767.00 / $5,500.00 / $9,419.00
| Facility | | $1,767.00 | $5,500.00 | $9,419.00 |
- 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
- $55.00 / $21,141.45 / $21,141.45
| Facility | | $55.00 | $21,141.45 | $21,141.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,794.00 / $3,626.00 / $6,291.00
| Facility | | $1,794.00 | $3,626.00 | $6,291.00 |