- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,520.40 / $21,779.30 / $30,716.00
| Facility | | $15,520.40 | $21,779.30 | $30,716.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,485.34 / $23,561.15 / $29,581.04
| Facility | | $22,485.34 | $23,561.15 | $29,581.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,635.85 / $19,177.12 / $28,129.50
| Facility | | $12,635.85 | $19,177.12 | $28,129.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,465.14 / $18,607.59 / $33,578.26
| Facility | | $13,465.14 | $18,607.59 | $33,578.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $135.16 / $192.96 / $315.94
| Facility | | $135.16 | $192.96 | $315.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,913.15 / $20,612.15 / $32,718.93
| Facility | | $14,913.15 | $20,612.15 | $32,718.93 |