- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,638.00 / $22,752.00 / $27,960.10
| Facility | | $14,638.00 | $22,752.00 | $27,960.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,310.14 / $23,156.14 / $31,848.28
| Facility | | $15,310.14 | $23,156.14 | $31,848.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,353.70 / $22,743.44 / $33,482.00
| Facility | | $14,353.70 | $22,743.44 | $33,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,744.00 / $22,318.08 / $27,878.00
| Facility | | $14,744.00 | $22,318.08 | $27,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $20,518.00 / $37,912.87
| Facility | | $5,274.00 | $20,518.00 | $37,912.87 |