- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.71 / $4,723.00 / $11,627.00
| Facility | | $254.71 | $4,723.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.00 / $2,786.00 / $8,800.00
| Facility | | $1,145.00 | $2,786.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $223.26 / $223.26 / $325.08
| Facility | | $223.26 | $223.26 | $325.08 |
- 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
- $1,480.00 / $3,086.00 / $6,792.00
| Facility | | $1,480.00 | $3,086.00 | $6,792.00 |