- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $82.89 / $2,113.00 / $10,268.00
| Facility | | $82.89 | $2,113.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $937.00 / $1,927.00 / $3,943.00
| Facility | | $937.00 | $1,927.00 | $3,943.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.24 / $67.48 / $83.53
| Facility | | $56.24 | $67.48 | $83.53 |
- 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
- $464.44 / $1,452.00 / $3,923.00
| Facility | | $464.44 | $1,452.00 | $3,923.00 |