- 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
- $23,366.51 / $31,667.62 / $59,448.21
| Facility | | $23,366.51 | $31,667.62 | $59,448.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.48 / $966.81 / $19,233.14
| Facility | | $525.48 | $966.81 | $19,233.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $991.81 / $1,248.75 / $20,731.34
| Facility | | $991.81 | $1,248.75 | $20,731.34 |
- 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 |