- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,866.90 / $27,670.40 / $31,299.00
| Facility | | $17,866.90 | $27,670.40 | $31,299.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,525.97 / $26,531.10 / $37,421.54
| Facility | | $17,525.97 | $26,531.10 | $37,421.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,487.62 / $25,689.27 / $35,205.41
| Facility | | $16,487.62 | $25,689.27 | $35,205.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,916.00 / $26,805.00 / $33,370.00
| Facility | | $22,916.00 | $26,805.00 | $33,370.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $31,964.72 / $42,542.46
| Facility | | $5,274.00 | $31,964.72 | $42,542.46 |