- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $740.36 / $9,062.00 / $20,498.00
| Facility | | $740.36 | $9,062.00 | $20,498.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,580.29 / $13,294.56 / $26,616.25
| Facility | | $5,580.29 | $13,294.56 | $26,616.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $732.23 / $890.00 / $5,740.31
| Facility | | $732.23 | $890.00 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $704.04 / $914.00 / $1,437.46
| Facility | | $704.04 | $914.00 | $1,437.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,637.00 / $17,333.00 / $25,758.00
| Facility | | $3,637.00 | $17,333.00 | $25,758.00 |