- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $528.77 / $11,674.00 / $31,778.95
| Facility | | $528.77 | $11,674.00 | $31,778.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,465.61 / $77,835.64 / $133,996.89
| Facility | | $35,465.61 | $77,835.64 | $133,996.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,991.56 / $23,991.56 / $30,829.59
| Facility | | $23,991.56 | $23,991.56 | $30,829.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.90 / $528.77 / $861.06
| Facility | | $385.90 | $528.77 | $861.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,700.00 / $31,997.00 / $89,528.00
| Facility | | $1,700.00 | $31,997.00 | $89,528.00 |