- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,611.20 / $28,823.00 / $32,602.80
| Facility | | $18,611.20 | $28,823.00 | $32,602.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,783.43 / $26,920.87 / $37,971.30
| Facility | | $17,783.43 | $26,920.87 | $37,971.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,186.07 / $27,153.49 / $36,671.93
| Facility | | $17,186.07 | $27,153.49 | $36,671.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,618.00 / $25,780.00 / $32,575.00
| Facility | | $17,618.00 | $25,780.00 | $32,575.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $23,240.05 / $44,176.60
| Facility | | $5,274.00 | $23,240.05 | $44,176.60 |