- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $492.31 / $3,426.54 / $11,581.00
| Facility | | $492.31 | $3,426.54 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,931.00 / $4,426.00 / $19,117.00
| Facility | | $1,931.00 | $4,426.00 | $19,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $268.58 / $322.30 / $398.91
| Facility | | $268.58 | $322.30 | $398.91 |
- 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
- $3,788.28 / $3,788.28 / $3,788.28
| Facility | | $3,788.28 | $3,788.28 | $3,788.28 |
- 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 |