- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $397.00 / $3,539.00 / $10,126.00
| Facility | | $397.00 | $3,539.00 | $10,126.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.41 / $371.96 / $1,617.51
| Facility | | $30.41 | $371.96 | $1,617.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $532.00 / $1,779.56 / $4,031.00
| Facility | | $532.00 | $1,779.56 | $4,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,383.00 / $13,383.00 / $13,383.00
| Facility | | $13,383.00 | $13,383.00 | $13,383.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $906.00 / $3,374.00
| Facility | | $500.00 | $906.00 | $3,374.00 |