- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $176.42 / $1,794.00 / $6,681.00
| Facility | | $176.42 | $1,794.00 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,270.00 / $2,138.00 / $2,838.00
| Facility | | $1,270.00 | $2,138.00 | $2,838.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,282.00 / $12,282.00 / $12,282.00
| Facility | | $12,282.00 | $12,282.00 | $12,282.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $362.20 / $372.30 / $12,000.00
| Facility | | $362.20 | $372.30 | $12,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.00 / $1,456.00 / $15,656.00
| Facility | | $741.00 | $1,456.00 | $15,656.00 |