- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.65 / $5,706.00 / $11,627.00
| Facility | | $602.65 | $5,706.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,097.00 / $8,173.00 / $36,529.00
| Facility | | $2,097.00 | $8,173.00 | $36,529.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $322.24 / $322.24 / $469.23
| Facility | | $322.24 | $322.24 | $469.23 |
- 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 |