- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,946.40 / $24,684.70 / $27,934.60
| Facility | | $15,946.40 | $24,684.70 | $27,934.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,312.17 / $24,671.68 / $33,320.96
| Facility | | $16,312.17 | $24,671.68 | $33,320.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,715.33 / $20,283.45 / $31,013.00
| Facility | | $14,715.33 | $20,283.45 | $31,013.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.00 / $20,738.00 / $29,585.00
| Facility | | $14,056.00 | $20,738.00 | $29,585.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $28,528.77 / $37,969.50
| Facility | | $5,274.00 | $28,528.77 | $37,969.50 |