- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,142.80 / $23,451.50 / $26,526.90
| Facility | | $15,142.80 | $23,451.50 | $26,526.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,175.68 / $19,927.84 / $27,408.17
| Facility | | $13,175.68 | $19,927.84 | $27,408.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,973.78 / $21,577.64 / $32,945.55
| Facility | | $13,973.78 | $21,577.64 | $32,945.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,335.00 / $22,052.00 / $28,094.00
| Facility | | $14,335.00 | $22,052.00 | $28,094.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $22,560.20 / $35,969.51
| Facility | | $5,274.00 | $22,560.20 | $35,969.51 |