- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $614.64 / $3,401.00 / $10,635.00
| Facility | | $614.64 | $3,401.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,152.00 / $2,894.00 / $8,800.00
| Facility | | $1,152.00 | $2,894.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $390.84 / $469.01 / $580.51
| Facility | | $390.84 | $469.01 | $580.51 |
- 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 |