- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.54 / $4,590.00 / $10,817.74
| Facility | | $308.54 | $4,590.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,712.00 / $3,405.00 / $14,996.00
| Facility | | $1,712.00 | $3,405.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $198.30 / $237.96 / $294.52
| Facility | | $198.30 | $237.96 | $294.52 |
- 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
- $1,689.00 / $2,665.00 / $5,268.00
| Facility | | $1,689.00 | $2,665.00 | $5,268.00 |