- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,072.00 / $26,663.00 / $36,641.00
| Facility | | $17,072.00 | $26,663.00 | $36,641.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,553.17 / $22,801.92 / $32,014.06
| Facility | | $21,553.17 | $22,801.92 | $32,014.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,729.01 / $25,203.51 / $38,183.86
| Facility | | $15,729.01 | $25,203.51 | $38,183.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,816.21 / $24,484.10 / $37,925.94
| Facility | | $15,816.21 | $24,484.10 | $37,925.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,394.76 / $24,484.10 / $36,930.94
| Facility | | $14,394.76 | $24,484.10 | $36,930.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,403.00 / $28,967.21 / $40,727.65
| Facility | | $10,403.00 | $28,967.21 | $40,727.65 |