- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,130.49 / $4,261.00 / $12,154.00
| Facility | | $1,130.49 | $4,261.00 | $12,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,234.00 / $4,286.00 / $10,043.00
| Facility | | $2,234.00 | $4,286.00 | $10,043.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,530.00 / $2,530.00 / $2,530.00
| Facility | | $2,530.00 | $2,530.00 | $2,530.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $966.19 / $1,401.05 / $3,212.25
| Facility | | $966.19 | $1,401.05 | $3,212.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,189.00 / $3,300.00 / $11,186.00
| Facility | | $1,189.00 | $3,300.00 | $11,186.00 |