- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,641.40 / $25,760.50 / $29,152.20
| Facility | | $16,641.40 | $25,760.50 | $29,152.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,272.95 / $26,148.08 / $35,937.54
| Facility | | $17,272.95 | $26,148.08 | $35,937.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,356.70 / $21,167.51 / $32,790.61
| Facility | | $15,356.70 | $21,167.51 | $32,790.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,315.00 / $20,820.00 / $30,874.00
| Facility | | $14,315.00 | $20,820.00 | $30,874.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $29,772.20 / $39,529.24
| Facility | | $5,274.00 | $29,772.20 | $39,529.24 |