- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.67 / $375.67 / $4,828.00
| Facility | | $375.67 | $375.67 | $4,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,560.50 / $38,930.24 / $76,435.03
| Facility | | $18,560.50 | $38,930.24 | $76,435.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $823.73 / $1,168.16 / $2,810.16
| Facility | | $823.73 | $1,168.16 | $2,810.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $669.64 / $1,067.98 / $2,212.73
| Facility | | $669.64 | $1,067.98 | $2,212.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.57 / $760.20 / $45,983.47
| Facility | | $580.57 | $760.20 | $45,983.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,028.00 / $11,496.00 / $21,528.00
| Facility | | $5,028.00 | $11,496.00 | $21,528.00 |