- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,194.00 / $20,969.30 / $41,429.00
| Facility | | $5,194.00 | $20,969.30 | $41,429.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,332.37 / $17,127.91 / $19,778.06
| Facility | | $16,332.37 | $17,127.91 | $19,778.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,319.47 / $18,299.00 / $42,329.28
| Facility | | $6,319.47 | $18,299.00 | $42,329.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,947.08 / $24,049.49 / $36,988.87
| Facility | | $16,947.08 | $24,049.49 | $36,988.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,535.00 / $24,402.20 / $42,424.00
| Facility | | $3,535.00 | $24,402.20 | $42,424.00 |