- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $951.00 / $2,547.00 / $10,635.00
| Facility | | $951.00 | $2,547.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,861.00 / $3,554.00 / $19,117.00
| Facility | | $1,861.00 | $3,554.00 | $19,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $608.39 / $730.07 / $903.62
| Facility | | $608.39 | $730.07 | $903.62 |
- 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
- $4,070.00 / $8,448.00 / $13,382.00
| Facility | | $4,070.00 | $8,448.00 | $13,382.00 |