- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $820.56 / $6,728.80 / $33,243.00
| Facility | | $820.56 | $6,728.80 | $33,243.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,440.08 / $25,440.08 / $25,440.08
| Facility | | $25,440.08 | $25,440.08 | $25,440.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,372.00 / $28,379.00 / $43,997.11
| Facility | | $2,372.00 | $28,379.00 | $43,997.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,685.49 / $35,716.22 / $47,724.97
| Facility | | $23,685.49 | $35,716.22 | $47,724.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,346.51 / $44,314.48 / $61,166.77
| Facility | | $26,346.51 | $44,314.48 | $61,166.77 |