- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,390.10 / $19,550.09 / $29,987.00
| Facility | | $14,390.10 | $19,550.09 | $29,987.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,568.77 / $17,771.71 / $26,068.00
| Facility | | $11,568.77 | $17,771.71 | $26,068.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,553.47 / $17,330.82 / $31,368.00
| Facility | | $12,553.47 | $17,330.82 | $31,368.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.32 / $183.80 / $292.93
| Facility | | $125.32 | $183.80 | $292.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,827.01 / $19,136.05 / $31,493.47
| Facility | | $13,827.01 | $19,136.05 | $31,493.47 |