- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $667.71 / $2,602.00 / $10,635.00
| Facility | | $667.71 | $2,602.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.00 / $2,722.00 / $8,800.00
| Facility | | $1,145.00 | $2,722.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $477.48 / $572.98 / $709.18
| Facility | | $477.48 | $572.98 | $709.18 |
- 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
- $2,647.00 / $4,404.00 / $7,351.00
| Facility | | $2,647.00 | $4,404.00 | $7,351.00 |