- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,539.20 / $27,904.10 / $41,941.00
| Facility | | $20,539.20 | $27,904.10 | $41,941.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,912.81 / $24,830.52 / $37,122.62
| Facility | | $15,912.81 | $24,830.52 | $37,122.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,917.75 / $24,736.53 / $44,772.00
| Facility | | $17,917.75 | $24,736.53 | $44,772.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $255.36 / $418.10
| Facility | | $150.00 | $255.36 | $418.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,735.50 / $27,313.16 / $44,951.09
| Facility | | $19,735.50 | $27,313.16 | $44,951.09 |