- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,756.40 / $24,123.50 / $37,984.10
| Facility | | $17,756.40 | $24,123.50 | $37,984.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,049.49 / $21,518.09 / $32,082.30
| Facility | | $14,049.49 | $21,518.09 | $32,082.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,490.14 / $21,385.07 / $38,706.00
| Facility | | $15,490.14 | $21,385.07 | $38,706.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $220.76 / $361.46
| Facility | | $150.00 | $220.76 | $361.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,837.04 / $22,753.32 / $36,730.06
| Facility | | $15,837.04 | $22,753.32 | $36,730.06 |