- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,290.40 / $26,207.70 / $38,822.00
| Facility | | $19,290.40 | $26,207.70 | $38,822.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,210.00 / $23,387.46 / $34,962.37
| Facility | | $15,210.00 | $23,387.46 | $34,962.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,828.41 / $23,604.77 / $42,050.00
| Facility | | $16,828.41 | $23,604.77 | $42,050.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $239.83 / $392.68
| Facility | | $150.00 | $239.83 | $392.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,535.64 / $25,652.60 / $42,218.20
| Facility | | $18,535.64 | $25,652.60 | $42,218.20 |