- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $305.02 / $4,440.80 / $31,997.17
| Facility | | $305.02 | $4,440.80 | $31,997.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,609.72 / $37,461.39 / $77,615.14
| Facility | | $3,609.72 | $37,461.39 | $77,615.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.84 / $505.00 / $32,164.59
| Facility | | $501.84 | $505.00 | $32,164.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $188.46 / $333.32 / $560.67
| Facility | | $188.46 | $333.32 | $560.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,252.00 / $25,508.00 / $63,302.00
| Facility | | $4,252.00 | $25,508.00 | $63,302.00 |