- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $667.19 / $5,907.00 / $11,627.00
| Facility | | $667.19 | $5,907.00 | $11,627.00 |
- 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
- $353.77 / $353.77 / $515.13
| Facility | | $353.77 | $353.77 | $515.13 |
- 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 |