- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $475.16 / $5,217.00 / $11,627.00
| Facility | | $475.16 | $5,217.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,145.00 / $2,792.00 / $8,800.00
| Facility | | $1,145.00 | $2,792.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $287.88 / $345.46 / $427.57
| Facility | | $287.88 | $345.46 | $427.57 |
- 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
- $1,725.00 / $2,721.00 / $5,235.00
| Facility | | $1,725.00 | $2,721.00 | $5,235.00 |