- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $388.24 / $3,426.54 / $9,516.00
| Facility | | $388.24 | $3,426.54 | $9,516.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,152.00 / $2,894.00 / $8,800.00
| Facility | | $1,152.00 | $2,894.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $207.39 / $248.87 / $308.02
| Facility | | $207.39 | $248.87 | $308.02 |
- 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
- $1,784.46 / $3,384.21 / $4,314.60
| Facility | | $1,784.46 | $3,384.21 | $4,314.60 |
- 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 |