- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.46 / $204.30 / $250.60
| Facility | | $191.46 | $204.30 | $250.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $821.00 / $1,963.00 / $4,852.00
| Facility | | $821.00 | $1,963.00 | $4,852.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,365.00 / $25,365.00 / $25,365.00
| Facility | | $25,365.00 | $25,365.00 | $25,365.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $191.46 / $367.23 / $3,516.00
| Facility | | $191.46 | $367.23 | $3,516.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,185.00 / $3,233.00 / $11,343.00
| Facility | | $1,185.00 | $3,233.00 | $11,343.00 |