- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,207.60 / $22,743.70 / $34,267.00
| Facility | | $16,207.60 | $22,743.70 | $34,267.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,188.48 / $19,830.41 / $29,359.75
| Facility | | $13,188.48 | $19,830.41 | $29,359.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,139.07 / $19,519.83 / $35,330.00
| Facility | | $14,139.07 | $19,519.83 | $35,330.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.13 / $201.50 / $329.93
| Facility | | $141.13 | $201.50 | $329.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,573.46 / $21,553.07 / $35,471.32
| Facility | | $15,573.46 | $21,553.07 | $35,471.32 |