- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $946.76 / $14,567.00 / $49,073.55
| Facility | | $946.76 | $14,567.00 | $49,073.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,010.17 / $24,991.86 / $44,218.10
| Facility | | $7,010.17 | $24,991.86 | $44,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,583.27 / $9,583.27 / $12,314.68
| Facility | | $9,583.27 | $9,583.27 | $12,314.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.22 / $483.49 / $783.89
| Facility | | $356.22 | $483.49 | $783.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,340.00 / $24,040.00 / $41,346.00
| Facility | | $3,340.00 | $24,040.00 | $41,346.00 |