- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.13 / $4,085.00 / $10,268.00
| Facility | | $540.13 | $4,085.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.00 / $3,576.00 / $14,996.00
| Facility | | $1,760.00 | $3,576.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $357.02 / $389.47 / $567.12
| Facility | | $357.02 | $389.47 | $567.12 |
- 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
- $685.62 / $685.62 / $8,807.45
| Facility | | $685.62 | $685.62 | $8,807.45 |
- 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 |