- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.65 / $2,292.00 / $9,534.00
| Facility | | $143.65 | $2,292.00 | $9,534.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.00 / $2,722.00 / $8,800.00
| Facility | | $1,145.00 | $2,722.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78.52 / $94.22 / $116.63
| Facility | | $78.52 | $94.22 | $116.63 |
- 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 |