- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,179.70 / $26,606.20 / $30,399.00
| Facility | | $17,179.70 | $26,606.20 | $30,399.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,110.22 / $25,901.74 / $36,533.83
| Facility | | $17,110.22 | $25,901.74 | $36,533.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,864.23 / $24,480.18 / $34,480.00
| Facility | | $15,864.23 | $24,480.18 | $34,480.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,434.00 / $24,771.00 / $31,873.00
| Facility | | $16,434.00 | $24,771.00 | $31,873.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $24,813.28 / $40,807.98
| Facility | | $5,274.00 | $24,813.28 | $40,807.98 |