- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,515.28 / $3,029.50 / $10,234.00
| Facility | | $1,515.28 | $3,029.50 | $10,234.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,221.00 / $6,488.00 / $13,081.00
| Facility | | $2,221.00 | $6,488.00 | $13,081.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $525.00 / $17,483.00
| Facility | | $500.00 | $525.00 | $17,483.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,632.40 / $32,472.55 / $32,472.55
| Facility | | $12,632.40 | $32,472.55 | $32,472.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,697.00 / $9,311.00 / $18,353.00
| Facility | | $1,697.00 | $9,311.00 | $18,353.00 |