- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,463.40 / $25,485.10 / $28,840.40
| Facility | | $16,463.40 | $25,485.10 | $28,840.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,819.51 / $23,926.55 / $32,907.87
| Facility | | $15,819.51 | $23,926.55 | $32,907.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,192.49 / $23,459.51 / $33,718.00
| Facility | | $15,192.49 | $23,459.51 | $33,718.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,252.89 / $23,420.00 / $28,715.00
| Facility | | $15,252.89 | $23,420.00 | $28,715.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $29,453.83 / $39,200.68
| Facility | | $5,274.00 | $29,453.83 | $39,200.68 |