- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $526.16 / $2,547.00 / $10,635.00
| Facility | | $526.16 | $2,547.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $13,964.62 / $26,394.04
| Facility | | $5,577.00 | $13,964.62 | $26,394.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $307.89 / $307.89 / $448.34
| Facility | | $307.89 | $307.89 | $448.34 |
- 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 |