- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.15 / $2,113.00 / $10,268.00
| Facility | | $116.15 | $2,113.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.00 / $2,722.00 / $8,800.00
| Facility | | $1,145.00 | $2,722.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.91 / $72.06 / $90.15
| Facility | | $61.91 | $72.06 | $90.15 |
- 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
- $1,106.00 / $2,048.00 / $4,132.00
| Facility | | $1,106.00 | $2,048.00 | $4,132.00 |