- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $5,315.00 / $14,487.00
| Facility | | $1,965.00 | $5,315.00 | $14,487.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,341.54 / $4,934.39 / $8,070.83
| Facility | | $1,341.54 | $4,934.39 | $8,070.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,874.05 / $10,874.05 / $10,874.05
| Facility | | $10,874.05 | $10,874.05 | $10,874.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $381.88 / $622.58 / $9,978.00
| Facility | | $381.88 | $622.58 | $9,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,315.00 / $7,341.00 / $11,396.00
| Facility | | $5,315.00 | $7,341.00 | $11,396.00 |