- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,501.20 / $21,059.60 / $31,791.00
| Facility | | $15,501.20 | $21,059.60 | $31,791.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,376.98 / $19,154.46 / $28,096.25
| Facility | | $12,376.98 | $19,154.46 | $28,096.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,522.76 / $18,668.98 / $33,790.00
| Facility | | $13,522.76 | $18,668.98 | $33,790.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.99 / $192.72 / $315.55
| Facility | | $134.99 | $192.72 | $315.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,894.63 / $20,613.59 / $33,925.16
| Facility | | $14,894.63 | $20,613.59 | $33,925.16 |