- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,575.40 / $25,658.30 / $29,036.50
| Facility | | $16,575.40 | $25,658.30 | $29,036.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,740.16 / $25,341.55 / $34,829.06
| Facility | | $16,740.16 | $25,341.55 | $34,829.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,295.77 / $21,083.52 / $32,660.49
| Facility | | $15,295.77 | $21,083.52 | $32,660.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,086.85 / $21,862.00 / $30,751.00
| Facility | | $15,086.85 | $21,862.00 | $30,751.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $29,654.06 / $39,467.17
| Facility | | $5,274.00 | $29,654.06 | $39,467.17 |