- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $573.80 / $5,706.00 / $11,627.00
| Facility | | $573.80 | $5,706.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,097.00 / $13,163.00 / $36,529.00
| Facility | | $2,097.00 | $13,163.00 | $36,529.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.48 / $308.48 / $449.20
| Facility | | $308.48 | $308.48 | $449.20 |
- 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
- $4,873.00 / $11,553.00 / $30,266.00
| Facility | | $4,873.00 | $11,553.00 | $30,266.00 |