- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $889.15 / $5,325.35 / $11,581.00
| Facility | | $889.15 | $5,325.35 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.00 / $3,967.00 / $14,996.00
| Facility | | $1,760.00 | $3,967.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $482.67 / $579.20 / $905.01
| Facility | | $482.67 | $579.20 | $905.01 |
- 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
- $2,608.62 / $4,956.00 / $7,778.00
| Facility | | $2,608.62 | $4,956.00 | $7,778.00 |