- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $511.00 / $5,097.89 / $12,765.09
| Facility | | $511.00 | $5,097.89 | $12,765.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,779.16 / $24,699.74 / $47,777.27
| Facility | | $18,779.16 | $24,699.74 | $47,777.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,085.00 / $5,085.00 / $5,085.00
| Facility | | $5,085.00 | $5,085.00 | $5,085.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.40 / $673.53 / $4,941.92
| Facility | | $344.40 | $673.53 | $4,941.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $532.70 / $798.42 / $971.19
| Facility | | $532.70 | $798.42 | $971.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.00 / $1,775.00 / $4,406.00
| Facility | | $1,031.00 | $1,775.00 | $4,406.00 |