- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $740.03 / $5,201.00 / $11,581.00
| Facility | | $740.03 | $5,201.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,202.00 / $5,480.00 / $25,522.00
| Facility | | $2,202.00 | $5,480.00 | $25,522.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.25 / $491.10 / $767.34
| Facility | | $409.25 | $491.10 | $767.34 |
- 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
- $4,070.00 / $8,448.00 / $13,382.00
| Facility | | $4,070.00 | $8,448.00 | $13,382.00 |