- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $19,054.61 / $22,908.68
| Facility | | $15,848.93 | $19,054.61 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $17,378.01 / $27,542.29
| Facility | | $16,982.44 | $17,378.01 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,135.61 / $19,498.45 / $30,902.95
| Facility | | $15,135.61 | $19,498.45 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $25,703.96 / $25,703.96
| Facility | | $12,302.69 | $25,703.96 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $21,877.62 / $32,359.37
| Facility | | $15,848.93 | $21,877.62 | $32,359.37 |