- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $454.61 / $5,355.00 / $11,581.00
| Facility | | $454.61 | $5,355.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,794.00 / $3,576.00 / $14,996.00
| Facility | | $1,794.00 | $3,576.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $289.86 / $347.83 / $543.50
| Facility | | $289.86 | $347.83 | $543.50 |
- 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 |