- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,695.20 / $22,115.10 / $38,693.00
| Facility | | $16,695.20 | $22,115.10 | $38,693.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,247.49 / $21,061.56 / $27,296.18
| Facility | | $17,247.49 | $21,061.56 | $27,296.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,707.53 / $18,488.81 / $37,797.39
| Facility | | $5,707.53 | $18,488.81 | $37,797.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,307.00 / $21,217.56 / $34,546.05
| Facility | | $13,307.00 | $21,217.56 | $34,546.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $22,790.62 / $34,809.86
| Facility | | $3,496.00 | $22,790.62 | $34,809.86 |