- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $797.41 / $10,709.64 / $37,864.39
| Facility | | $797.41 | $10,709.64 | $37,864.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,650.00 / $32,251.00 / $57,499.79
| Facility | | $3,650.00 | $32,251.00 | $57,499.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $774.10 / $986.60 / $1,138.38
| Facility | | $774.10 | $986.60 | $1,138.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,619.62 / $34,619.62 / $34,619.62
| Facility | | $34,619.62 | $34,619.62 | $34,619.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,619.00 / $16,546.00 / $34,320.00
| Facility | | $9,619.00 | $16,546.00 | $34,320.00 |