- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $427.31 / $3,922.84 / $19,071.00
| Facility | | $427.31 | $3,922.84 | $19,071.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,646.00 / $24,214.00 / $45,778.00
| Facility | | $1,646.00 | $24,214.00 | $45,778.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.54 / $631.49 / $4,511.97
| Facility | | $438.54 | $631.49 | $4,511.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,376.21 / $9,376.21 / $9,376.21
| Facility | | $9,376.21 | $9,376.21 | $9,376.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $12,296.00 / $17,380.00
| Facility | | $5,431.00 | $12,296.00 | $17,380.00 |