- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,100.00 / $6,060.00 / $17,328.00
| Facility | | $2,100.00 | $6,060.00 | $17,328.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,341.54 / $4,934.39 / $8,070.83
| Facility | | $1,341.54 | $4,934.39 | $8,070.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,992.72 / $13,992.72 / $13,992.72
| Facility | | $13,992.72 | $13,992.72 | $13,992.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $491.62 / $795.86 / $38,082.00
| Facility | | $491.62 | $795.86 | $38,082.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,962.00 / $25,147.00 / $139,004.00
| Facility | | $7,962.00 | $25,147.00 | $139,004.00 |