- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,905.00 / $21,484.00 / $37,102.00
| Facility | | $8,905.00 | $21,484.00 | $37,102.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,502.14 / $20,220.81 / $30,058.00
| Facility | | $13,502.14 | $20,220.81 | $30,058.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,467.23 / $20,292.80 / $36,150.00
| Facility | | $14,467.23 | $20,292.80 | $36,150.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.41 / $211.82 / $359.87
| Facility | | $144.41 | $211.82 | $359.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,326.00 / $22,053.31 / $34,960.67
| Facility | | $15,326.00 | $22,053.31 | $34,960.67 |