- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.83 / $5,355.00 / $10,817.74
| Facility | | $655.83 | $5,355.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,009.00 / $4,142.00 / $19,117.00
| Facility | | $2,009.00 | $4,142.00 | $19,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $418.03 / $501.64 / $783.81
| Facility | | $418.03 | $501.64 | $783.81 |
- 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 |