- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $185.46 / $2,113.00 / $10,268.00
| Facility | | $185.46 | $2,113.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,051.00 / $2,012.00 / $3,943.00
| Facility | | $1,051.00 | $2,012.00 | $3,943.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104.96 / $125.95 / $155.88
| Facility | | $104.96 | $125.95 | $155.88 |
- 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
- $444.00 / $979.00 / $3,218.00
| Facility | | $444.00 | $979.00 | $3,218.00 |