- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,565.50 / $23,864.20 / $35,414.00
| Facility | | $17,565.50 | $23,864.20 | $35,414.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,141.98 / $21,296.71 / $31,836.87
| Facility | | $14,141.98 | $21,296.71 | $31,836.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,323.66 / $21,155.23 / $38,290.00
| Facility | | $15,323.66 | $21,155.23 | $38,290.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $218.39 / $357.57
| Facility | | $150.00 | $218.39 | $357.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,878.23 / $23,358.81 / $38,443.16
| Facility | | $16,878.23 | $23,358.81 | $38,443.16 |