- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,847.00 / $27,589.20 / $54,507.80
| Facility | | $1,847.00 | $27,589.20 | $54,507.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,658.82 / $11,658.82 / $11,658.82
| Facility | | $11,658.82 | $11,658.82 | $11,658.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,339.26 / $3,142.79 / $27,743.61
| Facility | | $1,339.26 | $3,142.79 | $27,743.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,470.00 / $17,856.00 / $55,426.06
| Facility | | $10,470.00 | $17,856.00 | $55,426.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $32,105.75 / $48,201.40
| Facility | | $3,496.00 | $32,105.75 | $48,201.40 |