- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.02 / $408.96 / $1,031.58
| Facility | | $275.02 | $408.96 | $1,031.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,093.00 / $7,313.00 / $17,584.00
| Facility | | $1,093.00 | $7,313.00 | $17,584.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.35 / $348.40 / $431.21
| Facility | | $283.35 | $348.40 | $431.21 |
- 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
- $1,689.00 / $2,665.00 / $5,268.00
| Facility | | $1,689.00 | $2,665.00 | $5,268.00 |