- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,868.30 / $27,235.10 / $38,562.00
| Facility | | $14,868.30 | $27,235.10 | $38,562.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,507.42 / $23,118.75 / $36,499.76
| Facility | | $14,507.42 | $23,118.75 | $36,499.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,458.52 / $24,499.41 / $43,588.34
| Facility | | $15,458.52 | $24,499.41 | $43,588.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $22,496.20 / $51,543.30
| Facility | | $7,117.00 | $22,496.20 | $51,543.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $22,611.60 / $45,804.06
| Facility | | $3,308.00 | $22,611.60 | $45,804.06 |