- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,057.53 / $3,798.66 / $9,863.00
| Facility | | $1,057.53 | $3,798.66 | $9,863.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,670.00 / $6,003.00 / $30,285.00
| Facility | | $2,670.00 | $6,003.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $570.71 / $622.60 / $906.60
| Facility | | $570.71 | $622.60 | $906.60 |
- 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
- $732.07 / $732.07 / $732.07
| Facility | | $732.07 | $732.07 | $732.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.00 / $8,448.00 / $13,676.00
| Facility | | $4,070.00 | $8,448.00 | $13,676.00 |