- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,940.00 / $27,046.80 / $41,152.00
| Facility | | $19,940.00 | $27,046.80 | $41,152.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,692.49 / $24,506.18 / $36,608.64
| Facility | | $15,692.49 | $24,506.18 | $36,608.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,672.03 / $24,397.30 / $44,158.00
| Facility | | $17,672.03 | $24,397.30 | $44,158.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $251.86 / $412.37
| Facility | | $150.00 | $251.86 | $412.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,464.84 / $26,938.59 / $44,334.63
| Facility | | $19,464.84 | $26,938.59 | $44,334.63 |