- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $5,100.00 / $28,500.00
| Facility | | $789.00 | $5,100.00 | $28,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,608.06 / $24,106.49 / $34,713.78
| Facility | | $16,608.06 | $24,106.49 | $34,713.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $21,868.41 / $34,291.04
| Facility | | $2,089.36 | $21,868.41 | $34,291.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,962.49 / $28,335.38 / $37,862.50
| Facility | | $16,962.49 | $28,335.38 | $37,862.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,102.05 / $30,041.70 / $45,425.71
| Facility | | $20,102.05 | $30,041.70 | $45,425.71 |