- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $671.63 / $6,003.00 / $11,627.00
| Facility | | $671.63 | $6,003.00 | $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
- $367.86 / $367.86 / $535.66
| Facility | | $367.86 | $367.86 | $535.66 |
- 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
- $9,541.00 / $31,432.00 / $80,030.00
| Facility | | $9,541.00 | $31,432.00 | $80,030.00 |