- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,930.00 / $8,101.00 / $14,670.00
| Facility | | $1,930.00 | $8,101.00 | $14,670.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,166.00 / $4,280.76 / $6,787.73
| Facility | | $3,166.00 | $4,280.76 | $6,787.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $914.00 / $914.00 / $914.00
| Facility | | $914.00 | $914.00 | $914.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $252.08 / $345.35 / $7,310.00
| Facility | | $252.08 | $345.35 | $7,310.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,967.00 / $4,960.00 / $11,732.00
| Facility | | $1,967.00 | $4,960.00 | $11,732.00 |