- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $632.66 / $7,439.00 / $12,780.55
| Facility | | $632.66 | $7,439.00 | $12,780.55 |
- 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
- $632.66 / $807.44 / $1,164.56
| Facility | | $632.66 | $807.44 | $1,164.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $902.00 / $1,557.00 / $11,999.00
| Facility | | $902.00 | $1,557.00 | $11,999.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $8,223.00 / $8,223.00
| Facility | | $55.00 | $8,223.00 | $8,223.00 |