- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $674.02 / $5,355.00 / $10,817.74
| Facility | | $674.02 | $5,355.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,185.00 / $10,766.00 / $60,320.00
| Facility | | $3,185.00 | $10,766.00 | $60,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.81 / $380.81 / $554.51
| Facility | | $380.81 | $380.81 | $554.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,541.00 / $31,432.00 / $80,030.00
| Facility | | $9,541.00 | $31,432.00 | $80,030.00 |