- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,947.00 / $17,881.00 / $58,443.70
| Facility | | $1,947.00 | $17,881.00 | $58,443.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,718.00 / $13,704.57 / $33,372.19
| Facility | | $9,718.00 | $13,704.57 | $33,372.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,071.48 / $40,018.12 / $64,139.49
| Facility | | $25,071.48 | $40,018.12 | $64,139.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,292.38 / $27,785.22 / $64,686.97
| Facility | | $12,292.38 | $27,785.22 | $64,686.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,290.00 / $26,156.64 / $58,475.57
| Facility | | $10,290.00 | $26,156.64 | $58,475.57 |