- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,245.20 / $28,256.30 / $31,961.70
| Facility | | $18,245.20 | $28,256.30 | $31,961.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,543.59 / $28,071.61 / $38,581.19
| Facility | | $18,543.59 | $28,071.61 | $38,581.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,339.00 / $23,207.53 / $35,950.80
| Facility | | $16,339.00 | $23,207.53 | $35,950.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,496.00 / $23,447.00 / $33,849.00
| Facility | | $15,496.00 | $23,447.00 | $33,849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $32,641.49 / $43,443.20
| Facility | | $5,274.00 | $32,641.49 | $43,443.20 |