- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,188.30 / $20,278.70 / $30,323.00
| Facility | | $15,188.30 | $20,278.70 | $30,323.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,016.49 / $18,668.57 / $27,439.90
| Facility | | $12,016.49 | $18,668.57 | $27,439.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,761.48 / $17,646.56 / $32,859.69
| Facility | | $12,761.48 | $17,646.56 | $32,859.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $132.27 / $188.83 / $309.18
| Facility | | $132.27 | $188.83 | $309.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,594.01 / $20,197.54 / $32,018.75
| Facility | | $14,594.01 | $20,197.54 | $32,018.75 |