- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,662.09 / $25,792.00 / $33,899.50
| Facility | | $17,662.09 | $25,792.00 | $33,899.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,471.03 / $20,346.43 / $34,413.24
| Facility | | $7,471.03 | $20,346.43 | $34,413.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,942.30 / $25,906.58 / $43,361.76
| Facility | | $17,942.30 | $25,906.58 | $43,361.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,216.56 / $28,912.09 / $42,214.00
| Facility | | $22,216.56 | $28,912.09 | $42,214.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,216.56 / $26,877.64 / $42,214.00
| Facility | | $22,216.56 | $26,877.64 | $42,214.00 |