- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $867.57 / $6,064.00 / $11,561.00
| Facility | | $867.57 | $6,064.00 | $11,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,003.00 / $4,918.00 / $19,117.00
| Facility | | $2,003.00 | $4,918.00 | $19,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.78 / $600.94 / $743.78
| Facility | | $500.78 | $600.94 | $743.78 |
- 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
- $2,840.00 / $5,998.00 / $7,847.00
| Facility | | $2,840.00 | $5,998.00 | $7,847.00 |