- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,960.50 / $22,939.40 / $34,767.00
| Facility | | $15,960.50 | $22,939.40 | $34,767.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,307.97 / $20,003.00 / $29,625.75
| Facility | | $13,307.97 | $20,003.00 | $29,625.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,260.73 / $19,687.79 / $35,634.00
| Facility | | $14,260.73 | $19,687.79 | $35,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $142.36 / $203.24 / $332.77
| Facility | | $142.36 | $203.24 | $332.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,903.92 / $21,738.52 / $34,461.64
| Facility | | $14,903.92 | $21,738.52 | $34,461.64 |