- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $718.06 / $7,026.00 / $12,124.22
| Facility | | $718.06 | $7,026.00 | $12,124.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,202.00 / $5,711.00 / $25,522.00
| Facility | | $2,202.00 | $5,711.00 | $25,522.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $428.69 / $514.42 / $636.73
| Facility | | $428.69 | $514.42 | $636.73 |
- 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
- $6,335.44 / $6,335.44 / $6,335.44
| Facility | | $6,335.44 | $6,335.44 | $6,335.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.00 / $8,448.00 / $13,382.00
| Facility | | $4,070.00 | $8,448.00 | $13,382.00 |