- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $553.54 / $3,370.41 / $11,581.00
| Facility | | $553.54 | $3,370.41 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.00 / $3,405.00 / $14,996.00
| Facility | | $1,760.00 | $3,405.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $343.55 / $374.78 / $545.75
| Facility | | $343.55 | $374.78 | $545.75 |
- 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
- $447.87 / $447.87 / $447.87
| Facility | | $447.87 | $447.87 | $447.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,233.00 / $4,223.00 / $6,522.00
| Facility | | $2,233.00 | $4,223.00 | $6,522.00 |