- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,732.40 / $22,732.40 / $34,611.00
| Facility | | $16,732.40 | $22,732.40 | $34,611.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,748.91 / $23,245.93 / $27,312.92
| Facility | | $14,748.91 | $23,245.93 | $27,312.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,621.63 / $20,345.16 / $30,324.00
| Facility | | $13,621.63 | $20,345.16 | $30,324.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,596.89 / $20,151.89 / $36,474.00
| Facility | | $14,596.89 | $20,151.89 | $36,474.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $145.71 / $208.03 / $340.61
| Facility | | $145.71 | $208.03 | $340.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,077.74 / $22,250.96 / $36,619.90
| Facility | | $16,077.74 | $22,250.96 | $36,619.90 |