- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $558.59 / $2,602.00 / $10,635.00
| Facility | | $558.59 | $2,602.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,152.00 / $2,792.00 / $8,800.00
| Facility | | $1,152.00 | $2,792.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.45 / $373.75 / $462.59
| Facility | | $311.45 | $373.75 | $462.59 |
- 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 |