- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,717.60 / $19,995.09 / $29,810.00
| Facility | | $14,717.60 | $19,995.09 | $29,810.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,366.20 / $18,121.27 / $21,941.31
| Facility | | $13,366.20 | $18,121.27 | $21,941.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,978.67 / $18,179.73 / $26,666.50
| Facility | | $11,978.67 | $18,179.73 | $26,666.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,839.22 / $17,725.31 / $32,082.00
| Facility | | $12,839.22 | $17,725.31 | $32,082.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.16 / $187.98 / $299.60
| Facility | | $128.16 | $187.98 | $299.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,141.75 / $19,571.62 / $31,026.50
| Facility | | $14,141.75 | $19,571.62 | $31,026.50 |