- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,726.97 / $6,953.60 / $20,889.38
| Facility | | $1,726.97 | $6,953.60 | $20,889.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $23,439.57
| Facility | | $606.10 | $606.10 | $23,439.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,726.97 / $2,359.94 / $3,257.57
| Facility | | $1,726.97 | $2,359.94 | $3,257.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,153.00 / $21,463.00 / $29,047.00
| Facility | | $8,153.00 | $21,463.00 | $29,047.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $67,612.85 / $77,463.60
| Facility | | $55.00 | $67,612.85 | $77,463.60 |