- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,594.32 / $2,464.15 / $13,764.00
| Facility | | $1,594.32 | $2,464.15 | $13,764.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $606.10
| Facility | | $606.10 | $606.10 | $606.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,594.32 / $1,953.29 / $3,174.74
| Facility | | $1,594.32 | $1,953.29 | $3,174.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,545.00 / $22,780.00
| Facility | | $4,015.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $20,541.62 / $20,541.62
| Facility | | $55.00 | $20,541.62 | $20,541.62 |