- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $866.29 / $7,144.00 / $24,827.00
| Facility | | $866.29 | $7,144.00 | $24,827.00 |
- 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
- $17,990.61 / $17,990.61 / $17,990.61
| Facility | | $17,990.61 | $17,990.61 | $17,990.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.34 / $1,089.78 / $34,618.46
| Facility | | $641.34 | $1,089.78 | $34,618.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $709.95 / $905.01 / $964.92
| Facility | | $709.95 | $905.01 | $964.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $642.80 / $642.80 / $645.74
| Facility | | $642.80 | $642.80 | $645.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,114.67 / $30,261.00 / $57,885.88
| Facility | | $23,114.67 | $30,261.00 | $57,885.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,960.00 / $16,613.00 / $26,417.00
| Facility | | $3,960.00 | $16,613.00 | $26,417.00 |