- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,376.00 / $4,474.00 / $12,473.00
| Facility | | $1,376.00 | $4,474.00 | $12,473.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.16 / $2,211.19 / $3,616.69
| Facility | | $601.16 | $2,211.19 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,143.90 / $10,143.90 / $10,143.90
| Facility | | $10,143.90 | $10,143.90 | $10,143.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $240.49 / $394.84 / $6,124.00
| Facility | | $240.49 | $394.84 | $6,124.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $4,545.00 / $7,217.00
| Facility | | $2,912.00 | $4,545.00 | $7,217.00 |