- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,106.00 / $23,606.70 / $30,079.50
| Facility | | $16,106.00 | $23,606.70 | $30,079.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,523.93 / $24,991.98 / $34,373.24
| Facility | | $16,523.93 | $24,991.98 | $34,373.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,421.48 / $24,467.42 / $34,480.00
| Facility | | $14,421.48 | $24,467.42 | $34,480.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,535.00 / $23,801.00 / $30,053.00
| Facility | | $15,535.00 | $23,801.00 | $30,053.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $17,950.14 / $40,786.71
| Facility | | $5,274.00 | $17,950.14 | $40,786.71 |