- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,560.00 / $16,414.40 / $44,741.40
| Facility | | $5,560.00 | $16,414.40 | $44,741.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $745.00 / $9,774.21 / $26,145.93
| Facility | | $745.00 | $9,774.21 | $26,145.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,294.48 / $4,679.39 / $10,035.86
| Facility | | $3,294.48 | $4,679.39 | $10,035.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,253.00 / $21,977.47 / $29,842.63
| Facility | | $5,253.00 | $21,977.47 | $29,842.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47,768.90 / $47,768.90 / $56,060.86
| Facility | | $47,768.90 | $47,768.90 | $56,060.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $845.00 / $5,832.00 / $30,514.85
| Facility | | $845.00 | $5,832.00 | $30,514.85 |