- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,258.10 / $23,619.20 / $26,728.90
| Facility | | $15,258.10 | $23,619.20 | $26,728.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,272.24 / $23,098.83 / $31,769.45
| Facility | | $15,272.24 | $23,098.83 | $31,769.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,089.71 / $21,741.91 / $33,196.36
| Facility | | $14,089.71 | $21,741.91 | $33,196.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,173.00 / $23,574.00 / $28,497.00
| Facility | | $15,173.00 | $23,574.00 | $28,497.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $22,393.31 / $36,243.33
| Facility | | $5,274.00 | $22,393.31 | $36,243.33 |