- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,116.14 / $5,410.00 / $10,817.74
| Facility | | $1,116.14 | $5,410.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.00 / $3,576.00 / $14,996.00
| Facility | | $1,760.00 | $3,576.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $692.44 / $830.93 / $1,028.46
| Facility | | $692.44 | $830.93 | $1,028.46 |
- 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
- $2,840.00 / $5,998.00 / $7,847.00
| Facility | | $2,840.00 | $5,998.00 | $7,847.00 |