- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,621.80 / $24,182.20 / $27,366.10
| Facility | | $15,621.80 | $24,182.20 | $27,366.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,497.39 / $23,439.36 / $31,656.62
| Facility | | $15,497.39 | $23,439.36 | $31,656.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,415.82 / $20,229.00 / $30,334.92
| Facility | | $14,415.82 | $20,229.00 | $30,334.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.00 / $20,076.00 / $28,927.00
| Facility | | $14,056.00 | $20,076.00 | $28,927.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $21,693.52 / $37,107.33
| Facility | | $5,274.00 | $21,693.52 | $37,107.33 |