- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,556.70 / $30,116.60 / $46,712.00
| Facility | | $22,556.70 | $30,116.60 | $46,712.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,316.00 / $27,205.14 / $40,753.64
| Facility | | $17,316.00 | $27,205.14 | $40,753.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,677.83 / $27,166.43 / $49,170.00
| Facility | | $19,677.83 | $27,166.43 | $49,170.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $280.44 / $459.17
| Facility | | $150.00 | $280.44 | $459.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,674.14 / $29,996.16 / $49,366.68
| Facility | | $21,674.14 | $29,996.16 | $49,366.68 |