- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,579.80 / $22,569.30 / $25,540.70
| Facility | | $14,579.80 | $22,569.30 | $25,540.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,619.09 / $22,110.95 / $29,862.50
| Facility | | $14,619.09 | $22,110.95 | $29,862.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,454.29 / $18,959.50 / $28,311.58
| Facility | | $13,454.29 | $18,959.50 | $28,311.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,557.63 / $19,893.00 / $27,049.00
| Facility | | $13,557.63 | $19,893.00 | $27,049.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $19,104.77 / $34,632.28
| Facility | | $5,274.00 | $19,104.77 | $34,632.28 |