- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.61 / $4,376.00 / $10,439.00
| Facility | | $436.61 | $4,376.00 | $10,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $2,743.69 / $3,313.63
| Facility | | $1,659.59 | $2,743.69 | $3,313.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,103.00 / $7,103.00 / $7,103.00
| Facility | | $7,103.00 | $7,103.00 | $7,103.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $214.80 / $503.59 / $5,562.00
| Facility | | $214.80 | $503.59 | $5,562.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,436.00 / $3,096.00 / $5,565.00
| Facility | | $1,436.00 | $3,096.00 | $5,565.00 |