- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $531.44 / $5,244.00 / $16,154.00
| Facility | | $531.44 | $5,244.00 | $16,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,794.00 / $58,320.00 / $77,978.00
| Facility | | $11,794.00 | $58,320.00 | $77,978.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $737.00 / $50,000.00 / $50,000.00
| Facility | | $737.00 | $50,000.00 | $50,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,011.75 / $12,361.00 / $12,614.00
| Facility | | $2,011.75 | $12,361.00 | $12,614.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,343.51 / $2,343.51 / $2,393.04
| Facility | | $2,343.51 | $2,343.51 | $2,393.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,610.00 / $13,497.00 / $17,761.00
| Facility | | $7,610.00 | $13,497.00 | $17,761.00 |