- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $455.73 / $7,517.00 / $36,225.00
| Facility | | $455.73 | $7,517.00 | $36,225.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,650.00 / $40,050.00 / $63,916.00
| Facility | | $3,650.00 | $40,050.00 | $63,916.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $358.65 / $457.11 / $527.42
| Facility | | $358.65 | $457.11 | $527.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,711.08 / $33,711.08 / $33,711.08
| Facility | | $33,711.08 | $33,711.08 | $33,711.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,200.00 / $21,800.00 / $62,211.00
| Facility | | $14,200.00 | $21,800.00 | $62,211.00 |