- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,217.57 / $5,194.00 / $10,492.00
| Facility | | $3,217.57 | $5,194.00 | $10,492.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,098.00 / $20,151.00 / $29,866.68
| Facility | | $12,098.00 | $20,151.00 | $29,866.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $843.00 / $843.00 / $843.00
| Facility | | $843.00 | $843.00 | $843.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,346.67 / $2,466.00 / $2,518.00
| Facility | | $2,346.67 | $2,466.00 | $2,518.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,242.00 / $4,647.00 / $9,973.00
| Facility | | $1,242.00 | $4,647.00 | $9,973.00 |