- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,074.03 / $5,355.00 / $11,581.00
| Facility | | $1,074.03 | $5,355.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,670.00 / $5,770.00 / $30,285.00
| Facility | | $2,670.00 | $5,770.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $663.96 / $852.14 / $1,131.75
| Facility | | $663.96 | $852.14 | $1,131.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $847.01 / $847.01 / $847.01
| Facility | | $847.01 | $847.01 | $847.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,840.00 / $5,625.00 / $7,847.00
| Facility | | $2,840.00 | $5,625.00 | $7,847.00 |