- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $6,085.00 / $24,203.40
| Facility | | $789.00 | $6,085.00 | $24,203.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,821.16 / $18,906.78 / $25,307.20
| Facility | | $17,821.16 | $18,906.78 | $25,307.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.00 / $19,402.65 / $30,333.77
| Facility | | $2,200.00 | $19,402.65 | $30,333.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,411.90 / $24,748.11 / $33,464.92
| Facility | | $16,411.90 | $24,748.11 | $33,464.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,255.75 / $27,476.66 / $39,674.79
| Facility | | $18,255.75 | $27,476.66 | $39,674.79 |