- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.71 / $5,355.00 / $10,817.74
| Facility | | $495.71 | $5,355.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,009.00 / $3,683.00 / $15,092.00
| Facility | | $2,009.00 | $3,683.00 | $15,092.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.27 / $379.52 / $469.74
| Facility | | $316.27 | $379.52 | $469.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,233.00 / $4,383.00 / $6,522.00
| Facility | | $2,233.00 | $4,383.00 | $6,522.00 |