- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,619.59 / $27,287.30 / $30,865.70
| Facility | | $17,619.59 | $27,287.30 | $30,865.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,781.41 / $25,403.98 / $35,831.76
| Facility | | $16,781.41 | $25,403.98 | $35,831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,270.39 / $25,333.64 / $34,835.00
| Facility | | $16,270.39 | $25,333.64 | $34,835.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,680.00 / $25,651.00 / $32,689.00
| Facility | | $16,680.00 | $25,651.00 | $32,689.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $31,522.21 / $41,953.52
| Facility | | $5,274.00 | $31,522.21 | $41,953.52 |