- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $5,100.00 / $15,024.00
| Facility | | $789.00 | $5,100.00 | $15,024.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,826.25 / $11,060.86 / $19,410.02
| Facility | | $8,826.25 | $11,060.86 | $19,410.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $12,010.02 / $18,399.52
| Facility | | $2,089.36 | $12,010.02 | $18,399.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,905.74 / $15,060.57 / $20,341.00
| Facility | | $9,905.74 | $15,060.57 | $20,341.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,773.59 / $16,322.73 / $23,946.53
| Facility | | $10,773.59 | $16,322.73 | $23,946.53 |