- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $25,078.26 / $25,078.26
| Facility | | $2,600.00 | $25,078.26 | $25,078.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $850.41 / $953.36 / $1,038.70
| Facility | | $850.41 | $953.36 | $1,038.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $914.16 / $914.16 / $914.16
| Facility | | $914.16 | $914.16 | $914.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,621.31 / $6,621.31 / $6,621.31
| Facility | | $6,621.31 | $6,621.31 | $6,621.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,749.50 / $2,749.50 / $2,749.50
| Facility | | $2,749.50 | $2,749.50 | $2,749.50 |