- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $632.22 / $2,318.00 / $11,093.00
| Facility | | $632.22 | $2,318.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,890.00 / $30,900.00
| Facility | | $3,473.00 | $7,890.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.24 / $865.03 / $1,297.55
| Facility | | $630.24 | $865.03 | $1,297.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,506.34 / $6,506.34 / $7,712.62
| Facility | | $6,506.34 | $6,506.34 | $7,712.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,472.00 / $10,113.00 / $15,750.00
| Facility | | $4,472.00 | $10,113.00 | $15,750.00 |