- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $970.00 / $6,085.00 / $23,604.30
| Facility | | $970.00 | $6,085.00 | $23,604.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,841.45 / $19,596.66 / $26,853.30
| Facility | | $16,841.45 | $19,596.66 | $26,853.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $18,644.45 / $29,128.85
| Facility | | $2,089.36 | $18,644.45 | $29,128.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,562.98 / $23,467.98 / $31,358.55
| Facility | | $15,562.98 | $23,467.98 | $31,358.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,159.70 / $25,644.75 / $38,905.83
| Facility | | $16,159.70 | $25,644.75 | $38,905.83 |