- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.34 / $2,581.07 / $6,681.00
| Facility | | $563.34 | $2,581.07 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,917.00 / $3,549.00 / $5,878.00
| Facility | | $1,917.00 | $3,549.00 | $5,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,282.00 / $12,282.00 / $12,282.00
| Facility | | $12,282.00 | $12,282.00 | $12,282.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,608.05 / $1,645.20 / $26,542.00
| Facility | | $1,608.05 | $1,645.20 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,299.23 / $4,482.00 / $19,000.00
| Facility | | $2,299.23 | $4,482.00 | $19,000.00 |