- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,237.80 / $19,979.40 / $27,817.00
| Facility | | $14,237.80 | $19,979.40 | $27,817.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,590.33 / $17,590.36 / $25,802.00
| Facility | | $11,590.33 | $17,590.36 | $25,802.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,420.61 / $17,147.39 / $31,036.00
| Facility | | $12,420.61 | $17,147.39 | $31,036.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.00 / $181.86 / $289.83
| Facility | | $125.00 | $181.86 | $289.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,262.59 / $19,662.86 / $28,989.18
| Facility | | $14,262.59 | $19,662.86 | $28,989.18 |