- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,589.70 / $29,178.30 / $39,155.00
| Facility | | $17,589.70 | $29,178.30 | $39,155.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,992.42 / $15,992.42 / $15,992.42
| Facility | | $15,992.42 | $15,992.42 | $15,992.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,616.85 / $24,673.24 / $39,478.12
| Facility | | $14,616.85 | $24,673.24 | $39,478.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,443.50 / $23,493.00 / $53,878.85
| Facility | | $14,443.50 | $23,493.00 | $53,878.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,340.20 / $22,803.87 / $32,783.69
| Facility | | $18,340.20 | $22,803.87 | $32,783.69 |