- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $227.85 / $2,472.00 / $17,001.05
| Facility | | $227.85 | $2,472.00 | $17,001.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,427.00 / $11,294.00 / $22,813.00
| Facility | | $4,427.00 | $11,294.00 | $22,813.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $212.03 / $270.23 / $1,127.33
| Facility | | $212.03 | $270.23 | $1,127.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,982.66 / $2,982.66 / $2,982.66
| Facility | | $2,982.66 | $2,982.66 | $2,982.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,025.00 / $11,038.00
| Facility | | $3,932.00 | $8,025.00 | $11,038.00 |