- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,797.40 / $23,971.30 / $36,704.40
| Facility | | $18,797.40 | $23,971.30 | $36,704.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,043.50 / $23,627.96 / $31,504.31
| Facility | | $18,043.50 | $23,627.96 | $31,504.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,185.26 / $24,663.66 / $34,378.31
| Facility | | $16,185.26 | $24,663.66 | $34,378.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,867.00 / $13,867.00 / $13,867.00
| Facility | | $13,867.00 | $13,867.00 | $13,867.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,845.00 / $25,214.77 / $35,614.00
| Facility | | $10,845.00 | $25,214.77 | $35,614.00 |