- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,059.80 / $21,133.00 / $29,810.00
| Facility | | $15,059.80 | $21,133.00 | $29,810.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,018.12 / $18,599.09 / $27,207.78
| Facility | | $12,018.12 | $18,599.09 | $27,207.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,137.77 / $18,428.00 / $32,828.00
| Facility | | $13,137.77 | $18,428.00 | $32,828.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.15 / $187.23 / $306.56
| Facility | | $131.15 | $187.23 | $306.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,470.58 / $20,026.72 / $32,959.31
| Facility | | $14,470.58 | $20,026.72 | $32,959.31 |