- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,158.00 / $29,302.00 / $37,276.00
| Facility | | $4,158.00 | $29,302.00 | $37,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,849.50 / $23,048.35 / $29,664.39
| Facility | | $16,849.50 | $23,048.35 | $29,664.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,461.50 / $25,866.00 / $73,764.00
| Facility | | $10,461.50 | $25,866.00 | $73,764.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,651.22 / $22,802.84 / $29,302.00
| Facility | | $12,651.22 | $22,802.84 | $29,302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,564.00 / $23,478.00 / $43,930.83
| Facility | | $17,564.00 | $23,478.00 | $43,930.83 |