- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,189.27 / $2,524.38 / $7,602.00
| Facility | | $1,189.27 | $2,524.38 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,852.00 / $5,467.00 / $9,283.00
| Facility | | $1,852.00 | $5,467.00 | $9,283.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,134.54 / $16,394.00 / $22,211.50
| Facility | | $7,134.54 | $16,394.00 | $22,211.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,905.00 / $6,073.00 / $10,287.00
| Facility | | $2,905.00 | $6,073.00 | $10,287.00 |