- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,055.40 / $23,171.20 / $34,916.00
| Facility | | $17,055.40 | $23,171.20 | $34,916.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,883.01 / $20,673.93 / $30,905.87
| Facility | | $13,883.01 | $20,673.93 | $30,905.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,878.64 / $20,540.84 / $37,178.00
| Facility | | $14,878.64 | $20,540.84 | $37,178.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $148.53 / $212.04 / $347.19
| Facility | | $148.53 | $212.04 | $347.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,549.70 / $22,650.70 / $35,954.83
| Facility | | $15,549.70 | $22,650.70 | $35,954.83 |