- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $453.57 / $8,553.00 / $11,627.00
| Facility | | $453.57 | $8,553.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.00 / $3,528.00 / $14,996.00
| Facility | | $1,760.00 | $3,528.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $433.79 / $520.54 / $644.29
| Facility | | $433.79 | $520.54 | $644.29 |
- 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 |