- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,072.00 / $24,552.30 / $37,287.00
| Facility | | $18,072.00 | $24,552.30 | $37,287.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,548.15 / $21,908.37 / $32,751.25
| Facility | | $14,548.15 | $21,908.37 | $32,751.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,678.81 / $21,014.73 / $39,394.00
| Facility | | $15,678.81 | $21,014.73 | $39,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $224.68 / $367.88
| Facility | | $150.00 | $224.68 | $367.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,364.88 / $24,032.31 / $39,551.58
| Facility | | $17,364.88 | $24,032.31 | $39,551.58 |