- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $508.30 / $6,582.00 / $11,627.00
| Facility | | $508.30 | $6,582.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,129.00 / $14,299.15 / $25,723.30
| Facility | | $5,129.00 | $14,299.15 | $25,723.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $476.63 / $571.96 / $707.92
| Facility | | $476.63 | $571.96 | $707.92 |
- 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 / $6,111.00
| Facility | | $1,480.00 | $3,086.00 | $6,111.00 |