- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,983.20 / $22,252.10 / $26,344.00
| Facility | | $14,983.20 | $22,252.10 | $26,344.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,543.30 / $21,996.31 / $29,707.68
| Facility | | $14,543.30 | $21,996.31 | $29,707.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,268.07 / $19,512.48 / $27,900.83
| Facility | | $13,268.07 | $19,512.48 | $27,900.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.00 / $19,841.00 / $26,835.00
| Facility | | $14,056.00 | $19,841.00 | $26,835.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $19,789.00 / $34,105.43
| Facility | | $5,274.00 | $19,789.00 | $34,105.43 |