- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,964.40 / $20,999.10 / $32,987.00
| Facility | | $14,964.40 | $20,999.10 | $32,987.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,180.30 / $18,485.75 / $27,115.37
| Facility | | $12,180.30 | $18,485.75 | $27,115.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,573.38 / $17,386.46 / $32,375.35
| Facility | | $12,573.38 | $17,386.46 | $32,375.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.32 / $186.05 / $304.62
| Facility | | $130.32 | $186.05 | $304.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,643.32 / $19,873.74 / $31,546.80
| Facility | | $13,643.32 | $19,873.74 | $31,546.80 |