- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $760.52 / $3,278.00 / $10,635.00
| Facility | | $760.52 | $3,278.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,712.00 / $3,264.00 / $14,996.00
| Facility | | $1,712.00 | $3,264.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.79 / $682.51 / $906.47
| Facility | | $531.79 | $682.51 | $906.47 |
- 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
- $680.75 / $680.75 / $680.75
| Facility | | $680.75 | $680.75 | $680.75 |
- 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 |