- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,466.40 / $23,106.80 / $34,352.00
| Facility | | $16,466.40 | $23,106.80 | $34,352.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,405.06 / $20,122.50 / $29,841.87
| Facility | | $13,405.06 | $20,122.50 | $29,841.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,364.78 / $19,831.43 / $35,894.00
| Facility | | $14,364.78 | $19,831.43 | $35,894.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $143.40 / $204.72 / $335.20
| Facility | | $143.40 | $204.72 | $335.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,822.08 / $21,897.13 / $36,037.58
| Facility | | $15,822.08 | $21,897.13 | $36,037.58 |