- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.86 / $4,806.00 / $9,851.00
| Facility | | $525.86 | $4,806.00 | $9,851.00 |
- 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
- $365.39 / $438.47 / $542.71
| Facility | | $365.39 | $438.47 | $542.71 |
- 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
- $1,773.51 / $3,130.25 / $7,457.88
| Facility | | $1,773.51 | $3,130.25 | $7,457.88 |
- 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 |