- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $854.00 / $22,307.30 / $60,803.80
| Facility | | $854.00 | $22,307.30 | $60,803.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,826.00 / $2,826.00 / $35,579.74
| Facility | | $2,826.00 | $2,826.00 | $35,579.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,345.49 / $4,781.07 / $9,541.59
| Facility | | $3,345.49 | $4,781.07 | $9,541.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,392.00 / $29,411.97 / $40,348.94
| Facility | | $3,392.00 | $29,411.97 | $40,348.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64,917.05 / $64,917.05 / $76,185.67
| Facility | | $64,917.05 | $64,917.05 | $76,185.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $845.00 / $5,832.00 / $41,469.85
| Facility | | $845.00 | $5,832.00 | $41,469.85 |