- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.00 / $2,690.93 / $4,846.00
| Facility | | $2,318.00 | $2,690.93 | $4,846.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,838.00 / $16,821.03 / $25,253.12
| Facility | | $4,838.00 | $16,821.03 | $25,253.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,242.44 / $2,915.17 / $3,363.66
| Facility | | $2,242.44 | $2,915.17 | $3,363.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.00 / $761.00 / $2,917.75
| Facility | | $761.00 | $761.00 | $2,917.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.00 / $5,076.00 / $10,396.00
| Facility | | $612.00 | $5,076.00 | $10,396.00 |