- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,769.50 / $27,519.60 / $31,128.40
| Facility | | $17,769.50 | $27,519.60 | $31,128.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,288.56 / $26,171.71 / $36,914.62
| Facility | | $17,288.56 | $26,171.71 | $36,914.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,408.88 / $25,549.27 / $35,013.55
| Facility | | $16,408.88 | $25,549.27 | $35,013.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,928.00 / $25,651.00 / $35,179.00
| Facility | | $16,928.00 | $25,651.00 | $35,179.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $30,240.71 / $42,209.00
| Facility | | $5,274.00 | $30,240.71 | $42,209.00 |