- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $381.94 / $3,696.00 / $11,627.00
| Facility | | $381.94 | $3,696.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.00 / $2,786.00 / $8,800.00
| Facility | | $1,145.00 | $2,786.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.92 / $223.92 / $326.06
| Facility | | $223.92 | $223.92 | $326.06 |
- 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
- $1,020.00 / $1,940.00 / $4,132.00
| Facility | | $1,020.00 | $1,940.00 | $4,132.00 |