- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,962.60 / $29,227.00 / $44,554.90
| Facility | | $14,962.60 | $29,227.00 | $44,554.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,938.58 / $30,642.15 / $49,108.69
| Facility | | $18,938.58 | $30,642.15 | $49,108.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,860.91 / $28,306.85 / $50,362.38
| Facility | | $17,860.91 | $28,306.85 | $50,362.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.00 / $26,766.74 / $54,973.83
| Facility | | $7,117.00 | $26,766.74 | $54,973.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $26,125.65 / $52,922.45
| Facility | | $3,308.00 | $26,125.65 | $52,922.45 |