- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $651.21 / $651.21 / $5,618.00
| Facility | | $651.21 | $651.21 | $5,618.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,950.09 / $33,233.65 / $64,828.28
| Facility | | $13,950.09 | $33,233.65 | $64,828.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,468.91 / $2,083.09 / $5,011.17
| Facility | | $1,468.91 | $2,083.09 | $5,011.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,194.11 / $1,904.45 / $3,945.80
| Facility | | $1,194.11 | $1,904.45 | $3,945.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,046.47 / $1,357.58 / $43,296.38
| Facility | | $1,046.47 | $1,357.58 | $43,296.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $12,774.00
| Facility | | $5,577.00 | $10,743.00 | $12,774.00 |