- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.41 / $5,355.00 / $10,817.74
| Facility | | $606.41 | $5,355.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,185.00 / $10,766.00 / $60,320.00
| Facility | | $3,185.00 | $10,766.00 | $60,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $339.37 / $339.37 / $494.17
| Facility | | $339.37 | $339.37 | $494.17 |
- 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
- $4,873.00 / $11,553.00 / $30,266.00
| Facility | | $4,873.00 | $11,553.00 | $30,266.00 |