- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,711.90 / $25,869.70 / $29,275.70
| Facility | | $16,711.90 | $25,869.70 | $29,275.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,588.79 / $23,577.59 / $32,427.93
| Facility | | $15,588.79 | $23,577.59 | $32,427.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,432.22 / $24,028.57 / $33,482.00
| Facility | | $15,432.22 | $24,028.57 | $33,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,820.00 / $24,606.00 / $31,005.00
| Facility | | $15,820.00 | $24,606.00 | $31,005.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $24,137.58 / $39,696.72
| Facility | | $5,274.00 | $24,137.58 | $39,696.72 |