- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $400.96 / $1,030.47 / $11,093.00
| Facility | | $400.96 | $1,030.47 | $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
- $388.33 / $504.83 / $734.49
| Facility | | $388.33 | $504.83 | $734.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,484.43 / $6,484.43 / $7,686.65
| Facility | | $6,484.43 | $6,484.43 | $7,686.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.00 / $12,330.00 / $17,416.00
| Facility | | $5,058.00 | $12,330.00 | $17,416.00 |