- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,790.30 / $23,561.30 / $34,653.00
| Facility | | $16,790.30 | $23,561.30 | $34,653.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,666.44 / $20,393.55 / $30,423.75
| Facility | | $13,666.44 | $20,393.55 | $30,423.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,647.32 / $20,340.00 / $36,600.00
| Facility | | $14,647.32 | $20,340.00 | $36,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.22 / $208.75 / $341.79
| Facility | | $146.22 | $208.75 | $341.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,133.28 / $22,327.83 / $36,746.40
| Facility | | $16,133.28 | $22,327.83 | $36,746.40 |