- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.37 / $2,756.00 / $9,504.00
| Facility | | $215.37 | $2,756.00 | $9,504.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,152.00 / $2,742.00 / $8,800.00
| Facility | | $1,152.00 | $2,742.00 | $8,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.10 / $174.12 / $215.51
| Facility | | $145.10 | $174.12 | $215.51 |
- 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
- $974.11 / $4,914.62 / $5,431.64
| Facility | | $974.11 | $4,914.62 | $5,431.64 |
- 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 |