- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,545.70 / $27,160.40 / $30,736.30
| Facility | | $17,545.70 | $27,160.40 | $30,736.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,996.53 / $25,729.63 / $35,362.43
| Facility | | $16,996.53 | $25,729.63 | $35,362.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,866.00 / $22,317.78 / $34,572.49
| Facility | | $15,866.00 | $22,317.78 | $34,572.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,490.00 / $21,897.00 / $32,552.00
| Facility | | $14,490.00 | $21,897.00 | $32,552.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $25,341.87 / $41,677.30
| Facility | | $5,274.00 | $25,341.87 | $41,677.30 |