- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $789.00 / $6,600.00 / $36,176.80
| Facility | | $789.00 | $6,600.00 | $36,176.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,266.78 / $35,348.36 / $50,438.10
| Facility | | $31,266.78 | $35,348.36 | $50,438.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.00 / $27,594.20 / $43,527.74
| Facility | | $2,200.00 | $27,594.20 | $43,527.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,531.54 / $35,967.86 / $48,061.22
| Facility | | $21,531.54 | $35,967.86 | $48,061.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,532.13 / $39,933.42 / $57,661.66
| Facility | | $26,532.13 | $39,933.42 | $57,661.66 |