- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,571.40 / $27,044.00 / $37,439.00
| Facility | | $16,571.40 | $27,044.00 | $37,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,628.53 / $24,408.96 / $36,459.42
| Facility | | $15,628.53 | $24,408.96 | $36,459.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,598.39 / $24,295.64 / $43,974.00
| Facility | | $17,598.39 | $24,295.64 | $43,974.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $250.81 / $410.65
| Facility | | $150.00 | $250.81 | $410.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,392.13 / $26,764.78 / $42,527.26
| Facility | | $18,392.13 | $26,764.78 | $42,527.26 |