- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $551.16 / $4,723.00 / $10,268.00
| Facility | | $551.16 | $4,723.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,712.00 / $3,287.00 / $14,996.00
| Facility | | $1,712.00 | $3,287.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.77 / $295.77 / $430.69
| Facility | | $295.77 | $295.77 | $430.69 |
- 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
- $2,840.00 / $5,920.00 / $7,847.00
| Facility | | $2,840.00 | $5,920.00 | $7,847.00 |