- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $4,044.00 / $10,635.00
| Facility | | $900.00 | $4,044.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,782.00 / $8,483.00 / $60,320.00
| Facility | | $2,782.00 | $8,483.00 | $60,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $504.07 / $604.88 / $748.68
| Facility | | $504.07 | $604.88 | $748.68 |
- 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
- $4,873.00 / $11,553.00 / $21,466.00
| Facility | | $4,873.00 | $11,553.00 | $21,466.00 |