- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $970.42 / $7,614.00 / $11,754.00
| Facility | | $970.42 | $7,614.00 | $11,754.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,304.00 / $3,175.00 / $8,800.00
| Facility | | $1,304.00 | $3,175.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.33 / $739.60 / $915.41
| Facility | | $616.33 | $739.60 | $915.41 |
- 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
- $2,233.00 / $4,383.00 / $6,522.00
| Facility | | $2,233.00 | $4,383.00 | $6,522.00 |