- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,336.50 / $28,987.40 / $41,278.00
| Facility | | $21,336.50 | $28,987.40 | $41,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,524.03 / $25,748.71 / $38,548.50
| Facility | | $16,524.03 | $25,748.71 | $38,548.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,613.30 / $25,696.78 / $46,510.00
| Facility | | $18,613.30 | $25,696.78 | $46,510.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $265.27 / $434.33
| Facility | | $150.00 | $265.27 | $434.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,373.67 / $29,466.41 / $43,442.67
| Facility | | $21,373.67 | $29,466.41 | $43,442.67 |