- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $460.26 / $5,597.00 / $11,581.00
| Facility | | $460.26 | $5,597.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,291.00 / $4,932.00 / $25,522.00
| Facility | | $2,291.00 | $4,932.00 | $25,522.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $291.30 / $349.56 / $432.65
| Facility | | $291.30 | $349.56 | $432.65 |
- 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
- $3,206.00 / $6,578.00 / $10,075.00
| Facility | | $3,206.00 | $6,578.00 | $10,075.00 |