- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,747.00 / $27,013.00 / $38,247.50
| Facility | | $14,747.00 | $27,013.00 | $38,247.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,351.25 / $22,951.34 / $36,317.93
| Facility | | $14,351.25 | $22,951.34 | $36,317.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,332.46 / $24,299.63 / $43,232.89
| Facility | | $15,332.46 | $24,299.63 | $43,232.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $23,525.08 / $51,122.97
| Facility | | $7,117.00 | $23,525.08 | $51,122.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $22,427.21 / $45,430.54
| Facility | | $3,308.00 | $22,427.21 | $45,430.54 |