- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,071.80 / $20,549.00 / $27,008.40
| Facility | | $14,071.80 | $20,549.00 | $27,008.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,091.22 / $17,275.38 / $20,711.12
| Facility | | $15,091.22 | $17,275.38 | $20,711.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,968.18 / $13,530.22 / $22,884.55
| Facility | | $4,968.18 | $13,530.22 | $22,884.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,295.01 / $20,640.31 / $34,547.22
| Facility | | $14,295.01 | $20,640.31 | $34,547.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,700.39 / $23,034.86 / $33,632.78
| Facility | | $17,700.39 | $23,034.86 | $33,632.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,700.39 / $21,413.98 / $33,632.78
| Facility | | $17,700.39 | $21,413.98 | $33,632.78 |