- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $632.96 / $6,519.00 / $11,461.61
| Facility | | $632.96 | $6,519.00 | $11,461.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $46,065.23
| Facility | | $606.10 | $606.10 | $46,065.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.14 / $862.12 / $1,167.71
| Facility | | $597.14 | $862.12 | $1,167.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,810.00 / $42,428.00 / $93,042.00
| Facility | | $22,810.00 | $42,428.00 | $93,042.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $132,877.96 / $152,237.35
| Facility | | $55.00 | $132,877.96 | $152,237.35 |