- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $488.29 / $1,975.54 / $6,446.00
| Facility | | $488.29 | $1,975.54 | $6,446.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,047.00 / $3,753.00 / $5,878.00
| Facility | | $2,047.00 | $3,753.00 | $5,878.00 |
- 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
- $1,698.80 / $1,853.12 / $26,542.00
| Facility | | $1,698.80 | $1,853.12 | $26,542.00 |
- 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 |