- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $11,668.15 / $24,068.03
| Facility | | $5,463.36 | $11,668.15 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,731.81 / $33,844.37 / $65,465.93
| Facility | | $25,731.81 | $33,844.37 | $65,465.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,266.39 / $1,887.18 / $40,166.00
| Facility | | $1,266.39 | $1,887.18 | $40,166.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,982.28 / $2,257.33 / $2,807.92
| Facility | | $1,982.28 | $2,257.33 | $2,807.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,221.00 / $14,143.00 / $40,166.00
| Facility | | $11,221.00 | $14,143.00 | $40,166.00 |