- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,899.40 / $21,600.60 / $32,516.00
| Facility | | $15,899.40 | $21,600.60 | $32,516.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,942.04 / $19,487.41 / $28,811.12
| Facility | | $12,942.04 | $19,487.41 | $28,811.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,870.13 / $19,148.55 / $34,658.00
| Facility | | $13,870.13 | $19,148.55 | $34,658.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.46 / $197.67 / $323.64
| Facility | | $138.46 | $197.67 | $323.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,277.25 / $21,143.11 / $34,796.62
| Facility | | $15,277.25 | $21,143.11 | $34,796.62 |