- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,515.00 / $5,551.00 / $16,900.00
| Facility | | $1,515.00 | $5,551.00 | $16,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,271.00 / $9,962.39 / $15,740.47
| Facility | | $6,271.00 | $9,962.39 | $15,740.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,016.89 / $22,016.89 / $22,016.89
| Facility | | $22,016.89 | $22,016.89 | $22,016.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,758.54 / $2,545.12 / $19,664.12
| Facility | | $1,758.54 | $2,545.12 | $19,664.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,228.00 / $11,829.54 / $20,423.23
| Facility | | $3,228.00 | $11,829.54 | $20,423.23 |