- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $363.41 / $3,021.00 / $8,286.85
| Facility | | $363.41 | $3,021.00 | $8,286.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,907.10 / $43,760.01 / $67,647.07
| Facility | | $27,907.10 | $43,760.01 | $67,647.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,713.80 / $31,713.80 / $31,713.80
| Facility | | $31,713.80 | $31,713.80 | $31,713.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $149.53 / $318.27 / $23,073.00
| Facility | | $149.53 | $318.27 | $23,073.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,860.00 / $20,100.00 / $36,311.37
| Facility | | $4,860.00 | $20,100.00 | $36,311.37 |