- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $390.67 / $390.67 / $4,828.00
| Facility | | $390.67 | $390.67 | $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
- $858.27 / $1,217.13 / $2,927.97
| Facility | | $858.27 | $1,217.13 | $2,927.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $697.71 / $1,112.75 / $2,305.48
| Facility | | $697.71 | $1,112.75 | $2,305.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $611.48 / $1,057.70 / $26,630.00
| Facility | | $611.48 | $1,057.70 | $26,630.00 |
- 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 |