- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,528.30 / $25,597.40 / $28,954.10
| Facility | | $16,528.30 | $25,597.40 | $28,954.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,383.50 / $24,779.57 / $33,466.68
| Facility | | $16,383.50 | $24,779.57 | $33,466.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,252.39 / $21,023.72 / $32,095.29
| Facility | | $15,252.39 | $21,023.72 | $32,095.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,496.00 / $22,034.00 / $30,870.00
| Facility | | $15,496.00 | $22,034.00 | $30,870.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $24,607.70 / $39,260.73
| Facility | | $5,274.00 | $24,607.70 | $39,260.73 |