- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,648.10 / $22,675.00 / $25,660.30
| Facility | | $14,648.10 | $22,675.00 | $25,660.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,031.69 / $21,222.53 / $29,188.85
| Facility | | $14,031.69 | $21,222.53 | $29,188.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,526.45 / $20,872.74 / $31,869.28
| Facility | | $13,526.45 | $20,872.74 | $31,869.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,200.00 / $22,861.00 / $27,878.00
| Facility | | $15,200.00 | $22,861.00 | $27,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $21,156.75 / $34,794.44
| Facility | | $5,274.00 | $21,156.75 | $34,794.44 |