- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,980.00 / $20,351.59 / $29,617.00
| Facility | | $14,980.00 | $20,351.59 | $29,617.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,887.78 / $18,508.41 / $27,148.62
| Facility | | $11,887.78 | $18,508.41 | $27,148.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,068.13 / $18,041.34 / $32,654.00
| Facility | | $13,068.13 | $18,041.34 | $32,654.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.44 / $191.34 / $304.94
| Facility | | $130.44 | $191.34 | $304.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,393.88 / $19,920.57 / $32,784.62
| Facility | | $14,393.88 | $19,920.57 | $32,784.62 |