- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $924.54 / $13,255.00 / $21,831.94
| Facility | | $924.54 | $13,255.00 | $21,831.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,065.00 / $9,219.00 / $37,919.46
| Facility | | $3,065.00 | $9,219.00 | $37,919.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $919.55 / $1,262.13 / $1,893.20
| Facility | | $919.55 | $1,262.13 | $1,893.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,816.56 / $11,816.56 / $14,007.37
| Facility | | $11,816.56 | $11,816.56 | $14,007.37 |
- 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 |