- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $547.65 / $2,547.00 / $10,635.00
| Facility | | $547.65 | $2,547.00 | $10,635.00 |
- 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
- $321.97 / $468.84 / $591.87
| Facility | | $321.97 | $468.84 | $591.87 |
- 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
- $2,326.58 / $4,956.00 / $7,778.00
| Facility | | $2,326.58 | $4,956.00 | $7,778.00 |