- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,941.60 / $21,657.90 / $32,123.00
| Facility | | $15,941.60 | $21,657.90 | $32,123.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,979.38 / $19,536.00 / $28,894.25
| Facility | | $12,979.38 | $19,536.00 | $28,894.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,906.95 / $19,506.91 / $34,750.00
| Facility | | $13,906.95 | $19,506.91 | $34,750.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.83 / $198.20 / $324.51
| Facility | | $138.83 | $198.20 | $324.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,317.80 / $21,199.24 / $34,889.00
| Facility | | $15,317.80 | $21,199.24 | $34,889.00 |