- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $820.56 / $12,168.00 / $39,660.30
| Facility | | $820.56 | $12,168.00 | $39,660.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,753.55 / $26,753.55 / $26,753.55
| Facility | | $26,753.55 | $26,753.55 | $26,753.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.00 / $31,793.69 / $49,076.49
| Facility | | $2,200.00 | $31,793.69 | $49,076.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,892.97 / $40,552.90 / $54,187.87
| Facility | | $26,892.97 | $40,552.90 | $54,187.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,914.34 / $45,023.97 / $65,012.14
| Facility | | $29,914.34 | $45,023.97 | $65,012.14 |