- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $411.63 / $1,299.73 / $11,093.00
| Facility | | $411.63 | $1,299.73 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,200.00 / $15,727.00
| Facility | | $3,473.00 | $7,200.00 | $15,727.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.66 / $415.05 / $1,313.74
| Facility | | $325.66 | $415.05 | $1,313.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,033.31 / $4,033.31 / $4,033.31
| Facility | | $4,033.31 | $4,033.31 | $4,033.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $12,296.00 / $17,380.00
| Facility | | $5,431.00 | $12,296.00 | $17,380.00 |