- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,475.70 / $25,504.10 / $28,862.00
| Facility | | $16,475.70 | $25,504.10 | $28,862.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,559.61 / $25,045.93 / $33,826.41
| Facility | | $16,559.61 | $25,045.93 | $33,826.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,203.85 / $20,956.82 / $31,993.15
| Facility | | $15,203.85 | $20,956.82 | $31,993.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.00 / $21,173.00 / $30,567.00
| Facility | | $14,056.00 | $21,173.00 | $30,567.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $22,879.38 / $39,135.78
| Facility | | $5,274.00 | $22,879.38 | $39,135.78 |