- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $5,100.00 / $15,542.00
| Facility | | $789.00 | $5,100.00 | $15,542.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.83 / $14,859.74 / $21,199.78
| Facility | | $11,231.83 | $14,859.74 | $21,199.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $12,424.08 / $18,939.78
| Facility | | $2,089.36 | $12,424.08 | $18,939.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,247.25 / $15,579.79 / $20,894.80
| Facility | | $10,247.25 | $15,579.79 | $20,894.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,145.02 / $16,885.47 / $24,772.11
| Facility | | $11,145.02 | $16,885.47 | $24,772.11 |