- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,158.00 / $9,476.00 / $26,357.00
| Facility | | $4,158.00 | $9,476.00 | $26,357.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,964.00 / $87,049.70 / $112,856.08
| Facility | | $8,964.00 | $87,049.70 | $112,856.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,510.00 / $41,604.50 / $103,678.41
| Facility | | $6,510.00 | $41,604.50 | $103,678.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,312.85 / $74,291.42 / $83,294.78
| Facility | | $50,312.85 | $74,291.42 | $83,294.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,560.00 / $5,475.00 / $174,709.18
| Facility | | $2,560.00 | $5,475.00 | $174,709.18 |