- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,292.70 / $23,672.90 / $26,789.60
| Facility | | $15,292.70 | $23,672.90 | $26,789.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,090.56 / $22,824.04 / $31,391.52
| Facility | | $15,090.56 | $22,824.04 | $31,391.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,121.74 / $21,791.35 / $33,271.83
| Facility | | $14,121.74 | $21,791.35 | $33,271.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,825.00 / $23,286.86 / $28,317.00
| Facility | | $14,825.00 | $23,286.86 | $28,317.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $26,440.63 / $36,325.74
| Facility | | $5,274.00 | $26,440.63 | $36,325.74 |