- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,127.98 / $4,323.00 / $71,591.00
| Facility | | $2,127.98 | $4,323.00 | $71,591.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,018.00 / $9,153.00 / $14,914.00
| Facility | | $5,018.00 | $9,153.00 | $14,914.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $38,331.01 / $39,376.54
| Facility | | $55.00 | $38,331.01 | $39,376.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,052.00 / $10,986.00 / $19,168.00
| Facility | | $5,052.00 | $10,986.00 | $19,168.00 |