- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,382.00 / $8,477.27 / $19,276.96
| Facility | | $4,382.00 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,828.69 / $16,873.23 / $32,638.27
| Facility | | $12,828.69 | $16,873.23 | $32,638.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $406.92 / $606.39 / $31,771.37
| Facility | | $406.92 | $606.39 | $31,771.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $632.55 / $955.98 / $26,630.95
| Facility | | $632.55 | $955.98 | $26,630.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |