- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,458.00 / $19,303.50 / $28,876.00
| Facility | | $14,458.00 | $19,303.50 | $28,876.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,542.08 / $17,862.38 / $26,130.08
| Facility | | $11,542.08 | $17,862.38 | $26,130.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,612.70 / $17,412.59 / $31,516.00
| Facility | | $12,612.70 | $17,412.59 | $31,516.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.91 / $184.67 / $294.31
| Facility | | $125.91 | $184.67 | $294.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,181.57 / $19,201.12 / $30,479.12
| Facility | | $13,181.57 | $19,201.12 | $30,479.12 |