- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,022.09 / $23,565.10 / $34,821.00
| Facility | | $17,022.09 | $23,565.10 | $34,821.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,964.75 / $21,029.81 / $31,437.87
| Facility | | $13,964.75 | $21,029.81 | $31,437.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,131.56 / $20,890.03 / $37,810.00
| Facility | | $15,131.56 | $20,890.03 | $37,810.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $221.55 / $376.40
| Facility | | $150.00 | $221.55 | $376.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,046.00 / $22,625.50 / $36,566.05
| Facility | | $13,046.00 | $22,625.50 | $36,566.05 |