- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,053.20 / $23,302.10 / $26,370.10
| Facility | | $15,053.20 | $23,302.10 | $26,370.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,859.84 / $22,475.08 / $30,911.57
| Facility | | $14,859.84 | $22,475.08 | $30,911.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,900.58 / $21,450.06 / $32,750.75
| Facility | | $13,900.58 | $21,450.06 | $32,750.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,737.00 / $22,926.00 / $27,987.00
| Facility | | $14,737.00 | $22,926.00 | $27,987.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,008.00 / $19,419.39 / $35,756.83
| Facility | | $4,008.00 | $19,419.39 | $35,756.83 |