- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $421.10 / $1,386.00 / $13,357.49
| Facility | | $421.10 | $1,386.00 | $13,357.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,646.00 / $26,904.00 / $50,875.00
| Facility | | $1,646.00 | $26,904.00 | $50,875.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $408.72 / $531.34 / $1,111.24
| Facility | | $408.72 | $531.34 | $1,111.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,914.54 / $6,914.54 / $8,196.51
| Facility | | $6,914.54 | $6,914.54 | $8,196.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.00 / $12,330.00 / $17,649.00
| Facility | | $5,431.00 | $12,330.00 | $17,649.00 |