- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $607.25 / $5,128.00 / $18,800.00
| Facility | | $607.25 | $5,128.00 | $18,800.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,176.29 / $30,261.00 / $57,885.88
| Facility | | $20,176.29 | $30,261.00 | $57,885.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,873.22 / $17,873.22 / $17,873.22
| Facility | | $17,873.22 | $17,873.22 | $17,873.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $461.42 / $849.68 / $27,175.75
| Facility | | $461.42 | $849.68 | $27,175.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $514.63 / $646.75 / $715.26
| Facility | | $514.63 | $646.75 | $715.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $451.64 / $451.64 / $457.00
| Facility | | $451.64 | $451.64 | $457.00 |
- 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 |