- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,248.00 / $23,603.60 / $26,711.20
| Facility | | $15,248.00 | $23,603.60 | $26,711.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,529.72 / $23,488.25 / $31,722.65
| Facility | | $15,529.72 | $23,488.25 | $31,722.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,070.87 / $19,689.00 / $29,609.04
| Facility | | $14,070.87 | $19,689.00 | $29,609.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.00 / $20,395.00 / $28,478.00
| Facility | | $14,056.00 | $20,395.00 | $28,478.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $26,434.81 / $36,219.40
| Facility | | $5,274.00 | $26,434.81 | $36,219.40 |