- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,773.00 / $21,573.00 / $28,354.30
| Facility | | $14,773.00 | $21,573.00 | $28,354.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,872.49 / $13,269.63 / $22,443.79
| Facility | | $4,872.49 | $13,269.63 | $22,443.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,007.34 / $21,668.83 / $36,268.73
| Facility | | $15,007.34 | $21,668.83 | $36,268.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,582.41 / $24,182.70 / $35,308.72
| Facility | | $18,582.41 | $24,182.70 | $35,308.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,582.41 / $22,481.05 / $35,308.72
| Facility | | $18,582.41 | $22,481.05 | $35,308.72 |