- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,185.80 / $26,065.60 / $37,736.00
| Facility | | $19,185.80 | $26,065.60 | $37,736.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,182.16 / $23,254.01 / $34,762.87
| Facility | | $15,182.16 | $23,254.01 | $34,762.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,120.29 / $22,291.13 / $41,508.33
| Facility | | $16,120.29 | $22,291.13 | $41,508.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $238.53 / $390.55
| Facility | | $150.00 | $238.53 | $390.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,435.14 / $25,513.51 / $41,989.29
| Facility | | $18,435.14 | $25,513.51 | $41,989.29 |