- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $820.56 / $12,168.00 / $25,574.00
| Facility | | $820.56 | $12,168.00 | $25,574.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,408.10 / $48,408.10 / $48,408.10
| Facility | | $48,408.10 | $48,408.10 | $48,408.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.00 / $18,957.11 / $29,617.33
| Facility | | $2,200.00 | $18,957.11 | $29,617.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,823.96 / $24,089.87 / $32,952.72
| Facility | | $15,823.96 | $24,089.87 | $32,952.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,928.15 / $26,492.33 / $39,558.26
| Facility | | $16,928.15 | $26,492.33 | $39,558.26 |