- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47.96 / $57.76 / $152.69
| Facility | | $47.96 | $57.76 | $152.69 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,500.00 / $2,500.00 / $2,500.00
| Professional | | $2,500.00 | $2,500.00 | $2,500.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,682.23 / $2,682.23 / $2,682.23
| Professional | | $2,682.23 | $2,682.23 | $2,682.23 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $393.93 / $638.07 / $801.00
| Professional | | $393.93 | $638.07 | $801.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $1,703.06
| Facility | | $100.00 | $100.00 | $1,703.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,703.06 / $1,703.06 / $1,703.06
| Professional | | $1,703.06 | $1,703.06 | $1,703.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $70.00 / $70.00 / $70.00
| Professional | | $70.00 | $70.00 | $70.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400,000.00 / $2,400,000.00 / $2,400,000.00
| Facility | | $2,400,000.00 | $2,400,000.00 | $2,400,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,682.23 / $2,682.23 / $2,682.23
| Professional | | $2,682.23 | $2,682.23 | $2,682.23 |