- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.10 / $3,983.00 / $10,268.00
| Facility | | $563.10 | $3,983.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,777.00 / $6,932.00 / $30,285.00
| Facility | | $2,777.00 | $6,932.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $373.51 / $407.46 / $593.32
| Facility | | $373.51 | $407.46 | $593.32 |
- 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
- $718.48 / $718.48 / $718.48
| Facility | | $718.48 | $718.48 | $718.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.00 / $8,440.00 / $13,382.00
| Facility | | $4,070.00 | $8,440.00 | $13,382.00 |