- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.19 / $6,944.00 / $11,581.00
| Facility | | $213.19 | $6,944.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.67 / $4,089.29 / $7,640.32
| Facility | | $1,965.67 | $4,089.29 | $7,640.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.67 / $180.09 / $227.34
| Facility | | $123.67 | $180.09 | $227.34 |
- 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 |