- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $397.32 / $1,386.00 / $14,063.00
| Facility | | $397.32 | $1,386.00 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,646.00 / $26,904.00 / $50,875.00
| Facility | | $1,646.00 | $26,904.00 | $50,875.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $329.48 / $419.93 / $484.53
| Facility | | $329.48 | $419.93 | $484.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,280.52 / $8,280.52 / $8,280.52
| Facility | | $8,280.52 | $8,280.52 | $8,280.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $12,296.00 / $17,380.00
| Facility | | $5,431.00 | $12,296.00 | $17,380.00 |