- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $287.26 / $5,128.00 / $20,680.40
| Facility | | $287.26 | $5,128.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,933.00 / $24,062.04 / $46,054.28
| Facility | | $11,933.00 | $24,062.04 | $46,054.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,342.74 / $10,342.74 / $10,342.74
| Facility | | $10,342.74 | $10,342.74 | $10,342.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $234.58 / $396.55 / $13,126.42
| Facility | | $234.58 | $396.55 | $13,126.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $254.93 / $303.60 / $351.13
| Facility | | $254.93 | $303.60 | $351.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $215.63 / $215.63 / $215.70
| Facility | | $215.63 | $215.63 | $215.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,816.01 / $24,075.80 / $46,054.28
| Facility | | $15,816.01 | $24,075.80 | $46,054.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $11,540.00 / $20,708.00
| Facility | | $3,028.00 | $11,540.00 | $20,708.00 |