- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $207.96 / $298.41 / $339.30
| Facility | | $207.96 | $298.41 | $339.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,053.00 / $28,053.00 / $28,053.00
| Facility | | $28,053.00 | $28,053.00 | $28,053.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $207.96 / $292.14 / $482.65
| Facility | | $207.96 | $292.14 | $482.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,172.00 / $4,086.00 / $7,778.00
| Facility | | $1,172.00 | $4,086.00 | $7,778.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $509.86 / $971.76
| Facility | | $55.00 | $509.86 | $971.76 |