- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.09 / $1,738.15 / $8,470.71
| Facility | | $150.09 | $1,738.15 | $8,470.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,932.00 / $6,503.00 / $50,599.85
| Facility | | $2,932.00 | $6,503.00 | $50,599.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $267.37 / $347.58 / $544.32
| Facility | | $267.37 | $347.58 | $544.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,364.13 / $26,364.13 / $31,252.09
| Facility | | $26,364.13 | $26,364.13 | $31,252.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,778.00 / $17,818.00 / $44,785.00
| Facility | | $8,778.00 | $17,818.00 | $44,785.00 |