- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,276.00 / $26,755.20 / $30,263.80
| Facility | | $17,276.00 | $26,755.20 | $30,263.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,490.30 / $26,477.11 / $36,389.74
| Facility | | $17,490.30 | $26,477.11 | $36,389.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,866.00 / $21,974.69 / $34,041.01
| Facility | | $15,866.00 | $21,974.69 | $34,041.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,131.00 / $22,303.00 / $32,051.00
| Facility | | $15,131.00 | $22,303.00 | $32,051.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $30,907.50 / $41,135.40
| Facility | | $5,274.00 | $30,907.50 | $41,135.40 |