- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $476.50 / $5,072.00 / $12,492.00
| Facility | | $476.50 | $5,072.00 | $12,492.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,674.00 / $6,565.00 / $30,285.00
| Facility | | $2,674.00 | $6,565.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $298.79 / $383.47 / $509.30
| Facility | | $298.79 | $383.47 | $509.30 |
- 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
- $574.08 / $574.08 / $574.08
| Facility | | $574.08 | $574.08 | $574.08 |
- 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 |