- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,115.80 / $3,686.00 / $10,635.00
| Facility | | $1,115.80 | $3,686.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,097.00 / $7,398.00 / $36,529.00
| Facility | | $2,097.00 | $7,398.00 | $36,529.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $711.96 / $854.35 / $1,057.44
| Facility | | $711.96 | $854.35 | $1,057.44 |
- 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
- $5,351.00 / $11,296.00 / $16,745.00
| Facility | | $5,351.00 | $11,296.00 | $16,745.00 |