- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,791.40 / $26,004.70 / $29,414.90
| Facility | | $16,791.40 | $26,004.70 | $29,414.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,229.48 / $26,082.28 / $36,788.49
| Facility | | $17,229.48 | $26,082.28 | $36,788.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,505.60 / $24,142.83 / $34,480.00
| Facility | | $15,505.60 | $24,142.83 | $34,480.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,955.00 / $24,756.00 / $31,361.00
| Facility | | $15,955.00 | $24,756.00 | $31,361.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $30,040.51 / $39,885.48
| Facility | | $5,274.00 | $30,040.51 | $39,885.48 |