- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $476.82 / $2,113.00 / $10,268.00
| Facility | | $476.82 | $2,113.00 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,051.00 / $2,012.00 / $3,943.00
| Facility | | $1,051.00 | $2,012.00 | $3,943.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $284.77 / $361.65 / $452.35
| Facility | | $284.77 | $361.65 | $452.35 |
- 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
- $548.15 / $548.15 / $548.15
| Facility | | $548.15 | $548.15 | $548.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $1,940.00 / $3,923.00
| Facility | | $1,020.00 | $1,940.00 | $3,923.00 |