- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,315.09 / $23,523.90 / $35,615.00
| Facility | | $17,315.09 | $23,523.90 | $35,615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,819.74 / $20,985.32 / $31,371.37
| Facility | | $13,819.74 | $20,985.32 | $31,371.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,105.15 / $20,853.56 / $37,744.00
| Facility | | $15,105.15 | $20,853.56 | $37,744.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $215.27 / $352.47
| Facility | | $150.00 | $215.27 | $352.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,270.57 / $22,972.89 / $36,502.22
| Facility | | $16,270.57 | $22,972.89 | $36,502.22 |