- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,537.80 / $20,956.30 / $23,715.40
| Facility | | $13,537.80 | $20,956.30 | $23,715.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,695.09 / $20,713.41 / $27,975.04
| Facility | | $13,695.09 | $20,713.41 | $27,975.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,501.22 / $17,219.87 / $26,288.24
| Facility | | $12,501.22 | $17,219.87 | $26,288.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,896.00 / $19,082.00 / $25,072.00
| Facility | | $12,896.00 | $19,082.00 | $25,072.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $19,553.18 / $32,157.22
| Facility | | $5,274.00 | $19,553.18 | $32,157.22 |