- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,022.50 / $24,485.00 / $35,355.00
| Facility | | $18,022.50 | $24,485.00 | $35,355.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,260.05 / $21,840.58 / $32,563.12
| Facility | | $14,260.05 | $21,840.58 | $32,563.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,635.83 / $21,607.30 / $38,991.36
| Facility | | $15,635.83 | $21,607.30 | $38,991.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $140.82 / $201.04 / $329.16
| Facility | | $140.82 | $201.04 | $329.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,317.27 / $23,966.42 / $39,443.14
| Facility | | $17,317.27 | $23,966.42 | $39,443.14 |