- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,331.40 / $28,389.70 / $32,112.70
| Facility | | $18,331.40 | $28,389.70 | $32,112.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,486.75 / $27,985.55 / $39,473.01
| Facility | | $18,486.75 | $27,985.55 | $39,473.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,927.70 / $26,357.09 / $36,120.61
| Facility | | $16,927.70 | $26,357.09 | $36,120.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,580.00 / $25,651.00 / $33,584.00
| Facility | | $16,580.00 | $25,651.00 | $33,584.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $26,476.65 / $43,543.57
| Facility | | $5,274.00 | $26,476.65 | $43,543.57 |