- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $6,085.00 / $24,794.30
| Facility | | $789.00 | $6,085.00 | $24,794.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,193.72 / $18,877.50 / $28,350.24
| Facility | | $18,193.72 | $18,877.50 | $28,350.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.00 / $19,876.36 / $31,074.36
| Facility | | $2,200.00 | $19,876.36 | $31,074.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,812.59 / $25,352.33 / $34,500.00
| Facility | | $16,812.59 | $25,352.33 | $34,500.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,701.46 / $28,147.49 / $40,643.44
| Facility | | $18,701.46 | $28,147.49 | $40,643.44 |