- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,711.20 / $25,903.50 / $41,387.00
| Facility | | $18,711.20 | $25,903.50 | $41,387.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,087.77 / $23,109.43 / $34,546.75
| Facility | | $15,087.77 | $23,109.43 | $34,546.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,020.07 / $22,152.55 / $41,250.29
| Facility | | $16,020.07 | $22,152.55 | $41,250.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $237.05 / $388.13
| Facility | | $150.00 | $237.05 | $388.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,320.53 / $25,354.90 / $41,728.25
| Facility | | $18,320.53 | $25,354.90 | $41,728.25 |