- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,508.20 / $22,458.40 / $25,415.30
| Facility | | $14,508.20 | $22,458.40 | $25,415.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,556.67 / $22,016.54 / $29,735.00
| Facility | | $14,556.67 | $22,016.54 | $29,735.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,397.26 / $18,454.13 / $28,172.49
| Facility | | $13,397.26 | $18,454.13 | $28,172.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,734.00 / $19,893.00 / $26,916.00
| Facility | | $13,734.00 | $19,893.00 | $26,916.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $25,955.81 / $34,545.10
| Facility | | $5,274.00 | $25,955.81 | $34,545.10 |