- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,899.40 / $27,720.70 / $31,355.90
| Facility | | $17,899.40 | $27,720.70 | $31,355.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,457.77 / $27,941.68 / $38,402.64
| Facility | | $18,457.77 | $27,941.68 | $38,402.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,096.95 / $22,767.63 / $35,269.36
| Facility | | $16,096.95 | $22,767.63 | $35,269.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,496.00 / $23,545.00 / $33,430.00
| Facility | | $15,496.00 | $23,545.00 | $33,430.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $25,852.68 / $42,517.39
| Facility | | $5,274.00 | $25,852.68 | $42,517.39 |