- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,562.80 / $24,645.30 / $35,258.00
| Facility | | $17,562.80 | $24,645.30 | $35,258.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,293.75 / $21,285.59 / $31,820.25
| Facility | | $14,293.75 | $21,285.59 | $31,820.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,321.26 / $21,151.91 / $38,284.00
| Facility | | $15,321.26 | $21,151.91 | $38,284.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $218.35 / $357.52
| Facility | | $150.00 | $218.35 | $357.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,672.23 / $22,505.25 / $36,329.60
| Facility | | $15,672.23 | $22,505.25 | $36,329.60 |