- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,262.00 / $24,957.30 / $52,223.40
| Facility | | $5,262.00 | $24,957.30 | $52,223.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,315.84 / $40,675.01 / $56,620.34
| Facility | | $17,315.84 | $40,675.01 | $56,620.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,144.40 / $33,127.87 / $49,145.65
| Facility | | $17,144.40 | $33,127.87 | $49,145.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $820.00 / $28,165.80 / $51,379.32
| Facility | | $820.00 | $28,165.80 | $51,379.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $820.00 / $24,981.84 / $52,966.40
| Facility | | $820.00 | $24,981.84 | $52,966.40 |