- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,427.09 / $26,393.40 / $39,666.00
| Facility | | $19,427.09 | $26,393.40 | $39,666.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,260.20 / $23,543.15 / $35,099.86
| Facility | | $15,260.20 | $23,543.15 | $35,099.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,947.66 / $23,397.27 / $42,348.00
| Facility | | $16,947.66 | $23,397.27 | $42,348.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $241.53 / $395.47
| Facility | | $150.00 | $241.53 | $395.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,667.00 / $25,834.40 / $42,517.39
| Facility | | $18,667.00 | $25,834.40 | $42,517.39 |