- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,525.00 / $26,500.60 / $43,074.60
| Facility | | $15,525.00 | $26,500.60 | $43,074.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,946.81 / $20,912.64 / $29,388.77
| Facility | | $13,946.81 | $20,912.64 | $29,388.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,312.61 / $21,056.04 / $33,217.94
| Facility | | $13,312.61 | $21,056.04 | $33,217.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,405.95 / $19,149.89 / $35,732.49
| Facility | | $10,405.95 | $19,149.89 | $35,732.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,553.00 / $21,991.86 / $30,250.26
| Facility | | $6,553.00 | $21,991.86 | $30,250.26 |