- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,050.70 / $21,806.30 / $32,787.00
| Facility | | $16,050.70 | $21,806.30 | $32,787.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,809.08 / $19,656.00 / $28,998.42
| Facility | | $12,809.08 | $19,656.00 | $28,998.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,002.20 / $19,330.87 / $34,988.00
| Facility | | $14,002.20 | $19,330.87 | $34,988.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.78 / $199.55 / $326.74
| Facility | | $139.78 | $199.55 | $326.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,422.71 / $21,344.43 / $35,127.94
| Facility | | $15,422.71 | $21,344.43 | $35,127.94 |