- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,902.10 / $23,068.20 / $26,105.40
| Facility | | $14,902.10 | $23,068.20 | $26,105.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,406.00 / $23,301.12 / $31,469.92
| Facility | | $15,406.00 | $23,301.12 | $31,469.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,751.73 / $18,955.23 / $29,059.00
| Facility | | $13,751.73 | $18,955.23 | $29,059.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.00 / $19,986.00 / $27,594.00
| Facility | | $14,056.00 | $19,986.00 | $27,594.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $26,660.62 / $35,483.14
| Facility | | $5,274.00 | $26,660.62 | $35,483.14 |