- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $5,100.00 / $31,471.00
| Facility | | $789.00 | $5,100.00 | $31,471.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,454.21 / $22,454.21 / $41,068.93
| Facility | | $22,454.21 | $22,454.21 | $41,068.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $24,148.06 / $37,865.68
| Facility | | $2,089.36 | $24,148.06 | $37,865.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,089.12 / $31,289.18 / $41,809.44
| Facility | | $18,089.12 | $31,289.18 | $41,809.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,567.56 / $34,191.40 / $50,161.07
| Facility | | $22,567.56 | $34,191.40 | $50,161.07 |