- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $4,778.89 / $13,841.56
| Facility | | $1,653.00 | $4,778.89 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,653.53 / $11,095.47 / $19,471.83
| Facility | | $7,653.53 | $11,095.47 | $19,471.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.51 / $189.89 / $312.04
| Facility | | $108.51 | $189.89 | $312.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.00 / $255.47 / $367.29
| Facility | | $212.00 | $255.47 | $367.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |