- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,738.70 / $20,023.80 / $30,261.00
| Facility | | $14,738.70 | $20,023.80 | $30,261.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,660.71 / $18,150.82 / $26,627.48
| Facility | | $11,660.71 | $18,150.82 | $26,627.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,857.63 / $17,750.72 / $32,128.00
| Facility | | $12,857.63 | $17,750.72 | $32,128.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.35 / $184.00 / $300.02
| Facility | | $128.35 | $184.00 | $300.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,162.02 / $19,599.68 / $32,256.51
| Facility | | $14,162.02 | $19,599.68 | $32,256.51 |