- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,826.60 / $21,403.30 / $24,221.30
| Facility | | $13,826.60 | $21,403.30 | $24,221.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,792.06 / $20,860.08 / $28,173.12
| Facility | | $13,792.06 | $20,860.08 | $28,173.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,767.86 / $17,980.00 / $26,848.95
| Facility | | $12,767.86 | $17,980.00 | $26,848.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,089.00 / $19,082.00 / $25,652.00
| Facility | | $13,089.00 | $19,082.00 | $25,652.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $19,970.24 / $32,843.11
| Facility | | $5,274.00 | $19,970.24 | $32,843.11 |