- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,840.59 / $26,081.00 / $29,501.10
| Facility | | $16,840.59 | $26,081.00 | $29,501.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,593.05 / $25,096.50 / $34,516.99
| Facility | | $16,593.05 | $25,096.50 | $34,516.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,551.07 / $24,213.63 / $34,480.00
| Facility | | $15,551.07 | $24,213.63 | $34,480.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,986.36 / $25,123.00 / $31,453.00
| Facility | | $16,986.36 | $25,123.00 | $31,453.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $24,763.82 / $40,002.44
| Facility | | $5,274.00 | $24,763.82 | $40,002.44 |