- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $5,100.00 / $40,227.90
| Facility | | $789.00 | $5,100.00 | $40,227.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,200.80 / $32,200.80 / $32,200.80
| Facility | | $32,200.80 | $32,200.80 | $32,200.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.36 / $30,867.34 / $48,401.93
| Facility | | $2,089.36 | $30,867.34 | $48,401.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,122.48 / $39,995.49 / $53,443.06
| Facility | | $23,122.48 | $39,995.49 | $53,443.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,847.06 / $43,705.26 / $66,305.59
| Facility | | $28,847.06 | $43,705.26 | $66,305.59 |