- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,170.00 / $4,888.00 / $36,378.00
| Facility | | $1,170.00 | $4,888.00 | $36,378.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,667.50 / $10,939.81 / $16,047.92
| Facility | | $2,667.50 | $10,939.81 | $16,047.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,836.00 / $27,131.00 / $37,605.00
| Facility | | $22,836.00 | $27,131.00 | $37,605.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $283.08 / $554.84 / $22,625.00
| Facility | | $283.08 | $554.84 | $22,625.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $631.00 / $11,202.00 / $29,702.00
| Facility | | $631.00 | $11,202.00 | $29,702.00 |