- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $703.21 / $9,062.00 / $18,276.00
| Facility | | $703.21 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,320.13 / $11,250.27 / $20,652.61
| Facility | | $5,320.13 | $11,250.27 | $20,652.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $702.49 / $715.00 / $13,919.47
| Facility | | $702.49 | $715.00 | $13,919.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $663.40 / $850.88 / $1,339.09
| Facility | | $663.40 | $850.88 | $1,339.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |