- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $445.46 / $6,064.00 / $11,561.00
| Facility | | $445.46 | $6,064.00 | $11,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,191.00 / $3,025.00 / $8,800.00
| Facility | | $1,191.00 | $3,025.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $256.41 / $307.69 / $380.83
| Facility | | $256.41 | $307.69 | $380.83 |
- 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
- $2,233.00 / $4,383.00 / $6,522.00
| Facility | | $2,233.00 | $4,383.00 | $6,522.00 |