- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $540.73 / $4,198.00 / $11,581.00
| Facility | | $540.73 | $4,198.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,152.00 / $3,025.00 / $8,800.00
| Facility | | $1,152.00 | $3,025.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $352.47 / $422.96 / $523.51
| Facility | | $352.47 | $422.96 | $523.51 |
- 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
- $2,647.00 / $4,410.00 / $7,427.00
| Facility | | $2,647.00 | $4,410.00 | $7,427.00 |