- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,480.80 / $27,072.40 / $30,622.60
| Facility | | $17,480.80 | $27,072.40 | $30,622.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,261.59 / $27,644.72 / $37,994.49
| Facility | | $18,261.59 | $27,644.72 | $37,994.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,866.00 / $22,235.21 / $34,444.58
| Facility | | $15,866.00 | $22,235.21 | $34,444.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.00 / $22,552.00 / $31,779.74
| Facility | | $14,056.00 | $22,552.00 | $31,779.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $25,248.11 / $41,523.11
| Facility | | $5,274.00 | $25,248.11 | $41,523.11 |