- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $555.38 / $3,265.00 / $10,635.00
| Facility | | $555.38 | $3,265.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.00 / $2,792.00 / $8,800.00
| Facility | | $1,145.00 | $2,792.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.89 / $325.89 / $474.54
| Facility | | $325.89 | $325.89 | $474.54 |
- 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
- $1,356.62 / $2,297.00 / $4,951.00
| Facility | | $1,356.62 | $2,297.00 | $4,951.00 |