- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $6,600.00 / $34,971.60
| Facility | | $789.00 | $6,600.00 | $34,971.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,492.62 / $30,775.73 / $40,089.78
| Facility | | $25,492.62 | $30,775.73 | $40,089.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.00 / $28,034.97 / $43,829.39
| Facility | | $2,200.00 | $28,034.97 | $43,829.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,406.30 / $35,758.65 / $47,781.67
| Facility | | $21,406.30 | $35,758.65 | $47,781.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,377.81 / $39,701.14 / $57,326.27
| Facility | | $26,377.81 | $39,701.14 | $57,326.27 |