- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,535.00 / $5,467.00 / $12,237.00
| Facility | | $1,535.00 | $5,467.00 | $12,237.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,411.10 / $3,382.24 / $5,633.92
| Facility | | $2,411.10 | $3,382.24 | $5,633.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $624.00 / $624.00 / $624.00
| Facility | | $624.00 | $624.00 | $624.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.58 / $1,279.61 / $6,239.00
| Facility | | $815.58 | $1,279.61 | $6,239.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,779.00 / $3,946.00 / $6,988.00
| Facility | | $1,779.00 | $3,946.00 | $6,988.00 |