- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,452.80 / $23,920.60 / $27,070.00
| Facility | | $15,452.80 | $23,920.60 | $27,070.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,090.77 / $21,311.88 / $28,783.30
| Facility | | $14,090.77 | $21,311.88 | $28,783.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,259.87 / $19,655.65 / $30,006.75
| Facility | | $14,259.87 | $19,655.65 | $30,006.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.00 / $20,339.00 / $28,614.00
| Facility | | $14,056.00 | $20,339.00 | $28,614.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $22,319.02 / $36,705.91
| Facility | | $5,274.00 | $22,319.02 | $36,705.91 |