- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,383.60 / $19,541.40 / $30,654.00
| Facility | | $14,383.60 | $19,541.40 | $30,654.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,579.44 / $17,771.71 / $26,068.00
| Facility | | $11,579.44 | $17,771.71 | $26,068.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,478.89 / $16,725.79 / $31,354.00
| Facility | | $12,478.89 | $16,725.79 | $31,354.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.26 / $183.72 / $292.80
| Facility | | $125.26 | $183.72 | $292.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,820.84 / $19,127.50 / $31,479.42
| Facility | | $13,820.84 | $19,127.50 | $31,479.42 |