- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $2,754.23 / $112,201.85
| Facility | | $478.63 | $2,754.23 | $112,201.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $1,445.44 / $10,232.93
| Facility | | $575.44 | $1,445.44 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $28,183.83 / $28,183.83
| Facility | | $28,183.83 | $28,183.83 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61.66 / $100.00 / $100.00
| Facility | | $61.66 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $4,265.80 / $4,466.84
| Facility | | $3,630.78 | $4,265.80 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $14,125.38 / $52,480.75
| Facility | | $2,344.23 | $14,125.38 | $52,480.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117.49 / $194.98 / $316.23
| Facility | | $117.49 | $194.98 | $316.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $4,365.16 / $4,677.35
| Facility | | $3,630.78 | $4,365.16 | $4,677.35 |