- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $824.93 / $8,553.00 / $11,561.00
| Facility | | $824.93 | $8,553.00 | $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
- $531.04 / $637.26 / $788.74
| Facility | | $531.04 | $637.26 | $788.74 |
- 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
- $2,233.00 / $4,383.00 / $6,522.00
| Facility | | $2,233.00 | $4,383.00 | $6,522.00 |