- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,932.90 / $27,772.70 / $31,414.70
| Facility | | $17,932.90 | $27,772.70 | $31,414.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,761.15 / $26,887.12 / $37,923.69
| Facility | | $17,761.15 | $26,887.12 | $37,923.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,559.77 / $25,784.21 / $35,335.51
| Facility | | $16,559.77 | $25,784.21 | $35,335.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,976.00 / $25,651.00 / $31,766.00
| Facility | | $16,976.00 | $25,651.00 | $31,766.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $24,902.95 / $42,597.15
| Facility | | $5,274.00 | $24,902.95 | $42,597.15 |