- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.33 / $2,475.00 / $10,268.00
| Facility | | $457.33 | $2,475.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,152.00 / $2,792.00 / $8,800.00
| Facility | | $1,152.00 | $2,792.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.80 / $281.76 / $440.25
| Facility | | $234.80 | $281.76 | $440.25 |
- 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
- $2,233.00 / $4,383.00 / $6,522.00
| Facility | | $2,233.00 | $4,383.00 | $6,522.00 |