- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,122.02 / $4,897.79 / $9,549.93
| Facility | | $1,122.02 | $4,897.79 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $47,863.01 / $97,723.72
| Facility | | $22,908.68 | $47,863.01 | $97,723.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $891.25 / $1,000.00
| Facility | | $851.14 | $891.25 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,445.44 / $1,659.59
| Facility | | $933.25 | $1,445.44 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $16,982.44 / $34,673.69
| Facility | | $8,709.64 | $16,982.44 | $34,673.69 |