- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,676.59 / $24,015.10 / $33,734.80
| Facility | | $17,676.59 | $24,015.10 | $33,734.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,991.40 / $21,429.12 / $31,949.66
| Facility | | $13,991.40 | $21,429.12 | $31,949.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,420.51 / $21,288.93 / $38,532.00
| Facility | | $15,420.51 | $21,288.93 | $38,532.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $219.77 / $359.83
| Facility | | $150.00 | $219.77 | $359.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,984.91 / $23,506.45 / $38,686.12
| Facility | | $16,984.91 | $23,506.45 | $38,686.12 |