- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,457.40 / $26,434.50 / $40,868.00
| Facility | | $19,457.40 | $26,434.50 | $40,868.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,268.50 / $23,586.49 / $35,166.18
| Facility | | $15,268.50 | $23,586.49 | $35,166.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,974.08 / $23,433.74 / $42,414.00
| Facility | | $16,974.08 | $23,433.74 | $42,414.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $241.91 / $396.08
| Facility | | $150.00 | $241.91 | $396.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,285.20 / $24,933.07 / $40,248.76
| Facility | | $17,285.20 | $24,933.07 | $40,248.76 |