- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.26 / $2,849.00 / $9,504.00
| Facility | | $175.26 | $2,849.00 | $9,504.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,152.00 / $2,894.00 / $8,800.00
| Facility | | $1,152.00 | $2,894.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.14 / $120.17 / $148.74
| Facility | | $100.14 | $120.17 | $148.74 |
- 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
- $2,466.00 / $4,404.00 / $6,522.00
| Facility | | $2,466.00 | $4,404.00 | $6,522.00 |