- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $638.12 / $6,470.00 / $27,982.24
| Facility | | $638.12 | $6,470.00 | $27,982.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,026.00 / $30,261.00 / $57,885.88
| Facility | | $16,026.00 | $30,261.00 | $57,885.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,546.99 / $17,546.99 / $17,546.99
| Facility | | $17,546.99 | $17,546.99 | $17,546.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $607.17 / $1,029.69 / $28,512.96
| Facility | | $607.17 | $1,029.69 | $28,512.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.62 / $859.78 / $918.00
| Facility | | $655.62 | $859.78 | $918.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.54 / $611.54 / $612.84
| Facility | | $611.54 | $611.54 | $612.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,080.98 / $30,261.00 / $57,885.88
| Facility | | $22,080.98 | $30,261.00 | $57,885.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,340.00 / $13,441.00 / $26,417.00
| Facility | | $3,340.00 | $13,441.00 | $26,417.00 |