- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,132.70 / $29,630.80 / $33,516.50
| Facility | | $19,132.70 | $29,630.80 | $33,516.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,574.40 / $31,145.87 / $42,806.42
| Facility | | $20,574.40 | $31,145.87 | $42,806.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,339.00 / $24,880.06 / $37,699.60
| Facility | | $16,339.00 | $24,880.06 | $37,699.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,496.00 / $25,282.00 / $35,736.00
| Facility | | $15,496.00 | $25,282.00 | $35,736.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,958.00 / $27,634.07 / $45,447.06
| Facility | | $4,958.00 | $27,634.07 | $45,447.06 |