- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $970.00 / $6,100.00 / $18,891.09
| Facility | | $970.00 | $6,100.00 | $18,891.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,549.04 / $15,578.01 / $21,606.57
| Facility | | $13,549.04 | $15,578.01 | $21,606.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $15,188.64 / $23,312.52
| Facility | | $2,089.36 | $15,188.64 | $23,312.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,455.43 / $18,781.99 / $25,097.01
| Facility | | $12,455.43 | $18,781.99 | $25,097.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,933.00 / $19,913.02 / $31,137.29
| Facility | | $12,933.00 | $19,913.02 | $31,137.29 |