- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,151.20 / $25,001.70 / $28,293.40
| Facility | | $16,151.20 | $25,001.70 | $28,293.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,618.19 / $24,325.35 / $36,595.00
| Facility | | $15,618.19 | $24,325.35 | $36,595.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,524.80 / $23,014.56 / $34,191.00
| Facility | | $14,524.80 | $23,014.56 | $34,191.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,565.00 / $23,132.27 / $29,013.00
| Facility | | $14,565.00 | $23,132.27 | $29,013.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $28,895.19 / $38,457.17
| Facility | | $5,274.00 | $28,895.19 | $38,457.17 |