- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $527.79 / $3,325.00 / $10,635.00
| Facility | | $527.79 | $3,325.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,003.00 / $3,555.00 / $19,117.00
| Facility | | $2,003.00 | $3,555.00 | $19,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $357.88 / $429.46 / $531.54
| Facility | | $357.88 | $429.46 | $531.54 |
- 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
- $2,233.00 / $4,383.00 / $6,522.00
| Facility | | $2,233.00 | $4,383.00 | $6,522.00 |