- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $667.62 / $5,128.00 / $20,680.40
| Facility | | $667.62 | $5,128.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,933.00 / $24,075.80 / $46,054.28
| Facility | | $11,933.00 | $24,075.80 | $46,054.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,635.01 / $14,635.01 / $14,635.01
| Facility | | $14,635.01 | $14,635.01 | $14,635.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $496.03 / $850.26 / $13,126.42
| Facility | | $496.03 | $850.26 | $13,126.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $556.16 / $700.10 / $743.24
| Facility | | $556.16 | $700.10 | $743.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $495.13 / $495.13 / $498.13
| Facility | | $495.13 | $495.13 | $498.13 |
- 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 |