- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.40 / $4,723.00 / $11,627.00
| Facility | | $1,120.40 | $4,723.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,426.00 / $12,098.50 / $21,233.00
| Facility | | $4,426.00 | $12,098.50 | $21,233.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.79 / $1,307.75 / $1,618.62
| Facility | | $1,089.79 | $1,307.75 | $1,618.62 |
- 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 |