- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,272.00 / $31,274.30 / $50,107.70
| Facility | | $17,272.00 | $31,274.30 | $50,107.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,804.16 / $28,256.60 / $42,328.74
| Facility | | $17,804.16 | $28,256.60 | $42,328.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,434.21 / $28,262.00 / $51,060.00
| Facility | | $20,434.21 | $28,262.00 | $51,060.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $153.18 / $291.22 / $476.82
| Facility | | $153.18 | $291.22 | $476.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,355.85 / $30,636.00 / $49,380.13
| Facility | | $21,355.85 | $30,636.00 | $49,380.13 |