- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,527.20 / $28,693.00 / $32,455.80
| Facility | | $18,527.20 | $28,693.00 | $32,455.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,920.53 / $27,128.40 / $38,264.03
| Facility | | $17,920.53 | $27,128.40 | $38,264.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,096.97 / $26,638.70 / $36,506.54
| Facility | | $17,096.97 | $26,638.70 | $36,506.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,905.00 / $25,651.00 / $33,766.00
| Facility | | $15,905.00 | $25,651.00 | $33,766.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $19,368.18 / $44,008.81
| Facility | | $5,274.00 | $19,368.18 | $44,008.81 |