- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,137.70 / $17,848.59 / $28,027.00
| Facility | | $13,137.70 | $17,848.59 | $28,027.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,694.17 / $16,307.08 / $23,895.78
| Facility | | $10,694.17 | $16,307.08 | $23,895.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,460.93 / $16,029.00 / $28,638.00
| Facility | | $11,460.93 | $16,029.00 | $28,638.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.00 / $167.80 / $267.44
| Facility | | $120.00 | $167.80 | $267.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,623.63 / $17,470.61 / $28,752.55
| Facility | | $12,623.63 | $17,470.61 | $28,752.55 |