- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,426.60 / $25,590.20 / $34,340.00
| Facility | | $15,426.60 | $25,590.20 | $34,340.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,245.11 / $14,650.26 / $21,085.78
| Facility | | $14,245.11 | $14,650.26 | $21,085.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,034.17 / $22,001.68 / $35,203.54
| Facility | | $13,034.17 | $22,001.68 | $35,203.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,667.34 / $20,604.00 / $47,253.21
| Facility | | $12,667.34 | $20,604.00 | $47,253.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,039.55 / $20,296.31 / $28,752.20
| Facility | | $15,039.55 | $20,296.31 | $28,752.20 |