- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,503.30 / $19,761.00 / $29,348.50
| Facility | | $14,503.30 | $19,761.00 | $29,348.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,516.36 / $18,995.78 / $27,863.50
| Facility | | $12,516.36 | $18,995.78 | $27,863.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,341.76 / $17,882.31 / $33,522.00
| Facility | | $13,341.76 | $17,882.31 | $33,522.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $133.91 / $191.19 / $313.05
| Facility | | $133.91 | $191.19 | $313.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,776.50 / $20,450.09 / $33,656.08
| Facility | | $14,776.50 | $20,450.09 | $33,656.08 |