- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $235.73 / $2,547.00 / $10,635.00
| Facility | | $235.73 | $2,547.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,485.00 / $3,092.00 / $14,996.00
| Facility | | $1,485.00 | $3,092.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.72 / $187.03 / $248.40
| Facility | | $145.72 | $187.03 | $248.40 |
- 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
- $186.37 / $186.37 / $186.37
| Facility | | $186.37 | $186.37 | $186.37 |
- 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 |