- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,207.00 / $26,028.60 / $33,165.50
| Facility | | $18,207.00 | $26,028.60 | $33,165.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,484.52 / $27,982.18 / $39,468.26
| Facility | | $18,484.52 | $27,982.18 | $39,468.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,482.68 / $27,622.14 / $37,304.85
| Facility | | $17,482.68 | $27,622.14 | $37,304.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,923.00 / $25,669.00 / $35,057.00
| Facility | | $17,923.00 | $25,669.00 | $35,057.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $27,344.71 / $44,971.19
| Facility | | $5,274.00 | $27,344.71 | $44,971.19 |