- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $450.84 / $2,040.00 / $10,268.00
| Facility | | $450.84 | $2,040.00 | $10,268.00 |
- 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
- $305.11 / $332.84 / $484.68
| Facility | | $305.11 | $332.84 | $484.68 |
- 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
- $583.70 / $583.70 / $3,542.47
| Facility | | $583.70 | $583.70 | $3,542.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,689.00 / $2,600.00 / $5,235.00
| Facility | | $1,689.00 | $2,600.00 | $5,235.00 |