- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.24 / $4,846.00 / $23,138.98
| Facility | | $842.24 | $4,846.00 | $23,138.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,473.00 / $7,890.00 / $30,900.00
| Facility | | $3,473.00 | $7,890.00 | $30,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $875.31 / $1,153.34 / $1,730.03
| Facility | | $875.31 | $1,153.34 | $1,730.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,307.01 / $6,307.01 / $7,476.35
| Facility | | $6,307.01 | $6,307.01 | $7,476.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,058.00 / $12,330.00 / $17,416.00
| Facility | | $5,058.00 | $12,330.00 | $17,416.00 |