- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,716.00 / $24,068.70 / $36,637.00
| Facility | | $17,716.00 | $24,068.70 | $36,637.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,260.14 / $21,474.65 / $32,102.87
| Facility | | $14,260.14 | $21,474.65 | $32,102.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,454.92 / $21,560.00 / $38,618.00
| Facility | | $15,454.92 | $21,560.00 | $38,618.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $220.26 / $360.63
| Facility | | $150.00 | $220.26 | $360.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,647.33 / $23,504.85 / $37,347.47
| Facility | | $16,647.33 | $23,504.85 | $37,347.47 |