- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $5,100.00 / $26,835.70
| Facility | | $789.00 | $5,100.00 | $26,835.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,224.44 / $19,147.03 / $35,627.57
| Facility | | $15,224.44 | $19,147.03 | $35,627.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $20,647.93 / $32,288.61
| Facility | | $2,089.36 | $20,647.93 | $32,288.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,971.96 / $26,680.73 / $35,651.51
| Facility | | $15,971.96 | $26,680.73 | $35,651.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,243.68 / $29,155.49 / $42,773.06
| Facility | | $19,243.68 | $29,155.49 | $42,773.06 |