- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,661.00 / $24,254.10 / $28,365.20
| Facility | | $15,661.00 | $24,254.10 | $28,365.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,972.21 / $24,157.51 / $33,225.53
| Facility | | $15,972.21 | $24,157.51 | $33,225.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,461.77 / $22,316.04 / $34,044.00
| Facility | | $14,461.77 | $22,316.04 | $34,044.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,253.00 / $24,439.00 / $28,912.00
| Facility | | $15,253.00 | $24,439.00 | $28,912.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $28,018.18 / $37,289.94
| Facility | | $5,274.00 | $28,018.18 | $37,289.94 |