- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,523.30 / $20,943.50 / $23,766.00
| Facility | | $13,523.30 | $20,943.50 | $23,766.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,964.61 / $22,633.55 / $31,129.52
| Facility | | $14,964.61 | $22,633.55 | $31,129.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,487.78 / $19,443.96 / $29,422.11
| Facility | | $12,487.78 | $19,443.96 | $29,422.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,851.00 / $23,516.00 / $27,381.00
| Facility | | $14,851.00 | $23,516.00 | $27,381.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,245.00 / $24,375.04 / $38,171.00
| Facility | | $7,245.00 | $24,375.04 | $38,171.00 |