- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,456.10 / $20,829.80 / $23,572.30
| Facility | | $13,456.10 | $20,829.80 | $23,572.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,205.78 / $19,973.34 / $27,470.77
| Facility | | $13,205.78 | $19,973.34 | $27,470.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,417.35 / $19,174.28 / $29,276.01
| Facility | | $12,417.35 | $19,174.28 | $29,276.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,235.00 / $22,480.00 / $27,357.00
| Facility | | $17,235.00 | $22,480.00 | $27,357.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $24,073.65 / $32,040.09
| Facility | | $5,274.00 | $24,073.65 | $32,040.09 |