- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $499.10 / $5,135.00 / $10,817.74
| Facility | | $499.10 | $5,135.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,003.00 / $4,847.00 / $19,117.00
| Facility | | $2,003.00 | $4,847.00 | $19,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $325.94 / $391.13 / $484.11
| Facility | | $325.94 | $391.13 | $484.11 |
- 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
- $3,648.94 / $5,726.00 / $9,483.00
| Facility | | $3,648.94 | $5,726.00 | $9,483.00 |