- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $477.73 / $3,602.00 / $10,268.00
| Facility | | $477.73 | $3,602.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.00 / $3,405.00 / $14,996.00
| Facility | | $1,760.00 | $3,405.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $306.08 / $367.30 / $454.61
| Facility | | $306.08 | $367.30 | $454.61 |
- 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
- $2,647.00 / $4,410.00 / $7,351.00
| Facility | | $2,647.00 | $4,410.00 | $7,351.00 |