- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $316.04 / $3,325.00 / $10,268.00
| Facility | | $316.04 | $3,325.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.00 / $3,405.00 / $14,996.00
| Facility | | $1,760.00 | $3,405.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $178.66 / $214.39 / $265.35
| Facility | | $178.66 | $214.39 | $265.35 |
- 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
- $6,945.81 / $6,945.81 / $13,206.00
| Facility | | $6,945.81 | $6,945.81 | $13,206.00 |
- 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 |