- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.96 / $1,615.00 / $11,124.00
| Facility | | $842.96 | $1,615.00 | $11,124.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $0.71 / $518.28 / $35,600.00
| Facility | | $0.71 | $518.28 | $35,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.96 / $1,027.85 / $1,576.46
| Facility | | $842.96 | $1,027.85 | $1,576.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $301.00 / $661.00 / $4,877.00
| Facility | | $301.00 | $661.00 | $4,877.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $6,252.80 / $7,682.24
| Facility | | $55.00 | $6,252.80 | $7,682.24 |