- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,316.00 / $16,901.00 / $48,313.90
| Facility | | $4,316.00 | $16,901.00 | $48,313.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,027.00 / $22,329.95 / $34,821.66
| Facility | | $5,027.00 | $22,329.95 | $34,821.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.56 / $13,592.28 / $22,813.10
| Facility | | $2,884.56 | $13,592.28 | $22,813.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,058.00 / $36,826.50 / $58,323.36
| Facility | | $19,058.00 | $36,826.50 | $58,323.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,572.00 / $13,473.00 / $56,445.20
| Facility | | $3,572.00 | $13,473.00 | $56,445.20 |