- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $383.42 / $1,386.00 / $11,093.00
| Facility | | $383.42 | $1,386.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,650.00 / $40,050.00 / $64,230.00
| Facility | | $3,650.00 | $40,050.00 | $64,230.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $317.95 / $405.24 / $467.58
| Facility | | $317.95 | $405.24 | $467.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,074.56 / $18,074.56 / $18,074.56
| Facility | | $18,074.56 | $18,074.56 | $18,074.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,258.00 / $15,855.00 / $24,051.00
| Facility | | $8,258.00 | $15,855.00 | $24,051.00 |