- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $901.44 / $6,015.00 / $13,151.00
| Facility | | $901.44 | $6,015.00 | $13,151.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,114.00 / $4,864.00 / $10,156.00
| Facility | | $2,114.00 | $4,864.00 | $10,156.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54,750.00 / $54,750.00 / $57,732.00
| Facility | | $54,750.00 | $54,750.00 | $57,732.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,039.31 / $23,595.00
| Facility | | $55.00 | $1,039.31 | $23,595.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,160.00 / $7,273.00 / $46,408.00
| Facility | | $3,160.00 | $7,273.00 | $46,408.00 |