- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,916.10 / $24,637.90 / $27,881.70
| Facility | | $15,916.10 | $24,637.90 | $27,881.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,833.30 / $20,922.46 / $28,257.36
| Facility | | $13,833.30 | $20,922.46 | $28,257.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,313.44 / $20,245.02 / $29,485.00
| Facility | | $14,313.44 | $20,245.02 | $29,485.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,926.00 / $19,978.29 / $29,472.00
| Facility | | $13,926.00 | $19,978.29 | $29,472.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $28,474.71 / $37,897.54
| Facility | | $5,274.00 | $28,474.71 | $37,897.54 |