- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $966.02 / $7,155.00 / $14,500.00
| Facility | | $966.02 | $7,155.00 | $14,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,304.00 / $3,175.00 / $8,800.00
| Facility | | $1,304.00 | $3,175.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $629.59 / $755.51 / $935.11
| Facility | | $629.59 | $755.51 | $935.11 |
- 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 |