- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.44 / $5,201.00 / $11,627.00
| Facility | | $562.44 | $5,201.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.00 / $2,792.00 / $8,800.00
| Facility | | $1,145.00 | $2,792.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.34 / $444.49 / $590.34
| Facility | | $346.34 | $444.49 | $590.34 |
- 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
- $444.18 / $444.18 / $444.18
| Facility | | $444.18 | $444.18 | $444.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,647.00 / $4,383.00 / $7,351.00
| Facility | | $2,647.00 | $4,383.00 | $7,351.00 |