- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $817.57 / $9,830.15 / $24,064.99
| Facility | | $817.57 | $9,830.15 | $24,064.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,575.00 / $24,214.00 / $45,778.00
| Facility | | $2,575.00 | $24,214.00 | $45,778.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $763.16 / $972.66 / $1,122.30
| Facility | | $763.16 | $972.66 | $1,122.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,561.47 / $6,561.47 / $6,561.47
| Facility | | $6,561.47 | $6,561.47 | $6,561.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,051.00 / $11,452.00 / $17,416.00
| Facility | | $5,051.00 | $11,452.00 | $17,416.00 |