- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $622.53 / $622.53 / $7,397.00
| Facility | | $622.53 | $622.53 | $7,397.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,088.66 / $22,802.40 / $44,489.13
| Facility | | $13,088.66 | $22,802.40 | $44,489.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,403.21 / $1,989.93 / $4,787.04
| Facility | | $1,403.21 | $1,989.93 | $4,787.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,140.71 / $1,819.27 / $3,769.33
| Facility | | $1,140.71 | $1,819.27 | $3,769.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $999.57 / $1,296.74 / $27,343.83
| Facility | | $999.57 | $1,296.74 | $27,343.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,028.00 / $11,496.00 / $21,528.00
| Facility | | $5,028.00 | $11,496.00 | $21,528.00 |