- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $5,086.00 / $25,857.20
| Facility | | $789.00 | $5,086.00 | $25,857.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,137.55 / $21,754.85 / $28,273.35
| Facility | | $19,137.55 | $21,754.85 | $28,273.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $19,840.55 / $31,111.23
| Facility | | $2,089.36 | $19,840.55 | $31,111.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,407.00 / $25,707.84 / $34,762.69
| Facility | | $15,407.00 | $25,707.84 | $34,762.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,674.64 / $22,843.60 / $36,590.18
| Facility | | $14,674.64 | $22,843.60 | $36,590.18 |