- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.14 / $2,318.00 / $11,093.00
| Facility | | $467.14 | $2,318.00 | $11,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,200.00 / $20,138.00
| Facility | | $3,473.00 | $7,200.00 | $20,138.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $468.08 / $596.57 / $688.35
| Facility | | $468.08 | $596.57 | $688.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,140.62 / $4,140.62 / $4,140.62
| Facility | | $4,140.62 | $4,140.62 | $4,140.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,699.00 / $10,000.00 / $15,750.00
| Facility | | $4,699.00 | $10,000.00 | $15,750.00 |