- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.25 / $1,386.00 / $7,212.00
| Facility | | $358.25 | $1,386.00 | $7,212.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,682.00 / $3,914.00 / $43,260.00
| Facility | | $1,682.00 | $3,914.00 | $43,260.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $370.14 / $522.54 / $783.81
| Facility | | $370.14 | $522.54 | $783.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,276.56 / $14,276.56 / $14,276.56
| Facility | | $14,276.56 | $14,276.56 | $14,276.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.00 / $8,025.00 / $11,038.00
| Facility | | $3,932.00 | $8,025.00 | $11,038.00 |