- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,976.70 / $27,140.00 / $38,124.50
| Facility | | $19,976.70 | $27,140.00 | $38,124.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,472.17 / $24,182.84 / $36,094.66
| Facility | | $15,472.17 | $24,182.84 | $36,094.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,427.11 / $24,059.17 / $43,546.00
| Facility | | $17,427.11 | $24,059.17 | $43,546.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $248.36 / $406.65
| Facility | | $150.00 | $248.36 | $406.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,195.08 / $26,565.24 / $43,720.18
| Facility | | $19,195.08 | $26,565.24 | $43,720.18 |