- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,636.40 / $27,313.30 / $30,895.10
| Facility | | $17,636.40 | $27,313.30 | $30,895.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,690.02 / $25,243.16 / $34,092.80
| Facility | | $16,690.02 | $25,243.16 | $34,092.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,866.00 / $22,433.09 / $34,246.86
| Facility | | $15,866.00 | $22,433.09 | $34,246.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.00 / $21,419.00 / $32,657.00
| Facility | | $14,056.00 | $21,419.00 | $32,657.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $25,472.81 / $41,892.64
| Facility | | $5,274.00 | $25,472.81 | $41,892.64 |