- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,721.50 / $27,791.00 / $31,450.00
| Facility | | $18,721.50 | $27,791.00 | $31,450.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,295.04 / $27,695.34 / $38,064.06
| Facility | | $18,295.04 | $27,695.34 | $38,064.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,578.37 / $23,346.07 / $35,375.22
| Facility | | $16,578.37 | $23,346.07 | $35,375.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,496.00 / $23,647.00 / $33,308.00
| Facility | | $15,496.00 | $23,647.00 | $33,308.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $24,930.92 / $42,645.00
| Facility | | $5,274.00 | $24,930.92 | $42,645.00 |