- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $970.00 / $6,085.00 / $17,716.90
| Facility | | $970.00 | $6,085.00 | $17,716.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,958.60 / $14,397.24 / $23,071.11
| Facility | | $12,958.60 | $14,397.24 | $23,071.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $14,244.52 / $21,928.45
| Facility | | $2,089.36 | $14,244.52 | $21,928.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,681.21 / $17,759.96 / $23,537.00
| Facility | | $11,681.21 | $17,759.96 | $23,537.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,955.72 / $18,434.43 / $28,238.62
| Facility | | $11,955.72 | $18,434.43 | $28,238.62 |