- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,070.00 / $7,655.00 / $58,010.27
| Facility | | $2,070.00 | $7,655.00 | $58,010.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,979.00 / $40,576.06 / $64,328.43
| Facility | | $28,979.00 | $40,576.06 | $64,328.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,097.00 / $22,968.00 / $34,239.00
| Facility | | $9,097.00 | $22,968.00 | $34,239.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.02 / $6,165.00 / $28,091.00
| Facility | | $506.02 | $6,165.00 | $28,091.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,500.00 / $9,741.00 / $33,021.00
| Facility | | $4,500.00 | $9,741.00 | $33,021.00 |