- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,047.60 / $23,293.50 / $26,360.30
| Facility | | $15,047.60 | $23,293.50 | $26,360.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,389.07 / $24,788.00 / $33,478.06
| Facility | | $16,389.07 | $24,788.00 | $33,478.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,886.00 / $19,140.30 / $29,650.26
| Facility | | $13,886.00 | $19,140.30 | $29,650.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.00 / $19,971.25 / $28,206.00
| Facility | | $14,056.00 | $19,971.25 | $28,206.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,033.00 / $15,730.65 / $35,743.53
| Facility | | $5,033.00 | $15,730.65 | $35,743.53 |