- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.28 / $2,113.00 / $10,268.00
| Facility | | $389.28 | $2,113.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,622.00 / $3,092.00 / $14,996.00
| Facility | | $1,622.00 | $3,092.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $241.15 / $309.50 / $411.06
| Facility | | $241.15 | $309.50 | $411.06 |
- 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
- $307.26 / $307.26 / $2,868.68
| Facility | | $307.26 | $307.26 | $2,868.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,233.00 / $4,321.00 / $6,522.00
| Facility | | $2,233.00 | $4,321.00 | $6,522.00 |