- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,825.20 / $24,217.00 / $34,018.40
| Facility | | $17,825.20 | $24,217.00 | $34,018.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,253.05 / $21,608.10 / $32,302.37
| Facility | | $14,253.05 | $21,608.10 | $32,302.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,550.17 / $21,467.94 / $38,856.00
| Facility | | $15,550.17 | $21,467.94 | $38,856.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $221.62 / $362.86
| Facility | | $150.00 | $221.62 | $362.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,251.52 / $23,673.02 / $37,577.64
| Facility | | $16,251.52 | $23,673.02 | $37,577.64 |