- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.98 / $1,386.00 / $7,212.00
| Facility | | $251.98 | $1,386.00 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,591.00 / $6,340.00 / $43,260.00
| Facility | | $2,591.00 | $6,340.00 | $43,260.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.96 / $266.32 / $307.29
| Facility | | $208.96 | $266.32 | $307.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,379.27 / $7,379.27 / $7,379.27
| Facility | | $7,379.27 | $7,379.27 | $7,379.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,348.00 / $11,284.00
| Facility | | $3,932.00 | $8,348.00 | $11,284.00 |