- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,202.00 / $19,794.09 / $24,325.20
| Facility | | $14,202.00 | $19,794.09 | $24,325.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,360.71 / $20,207.68 / $27,793.05
| Facility | | $13,360.71 | $20,207.68 | $27,793.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,487.65 / $18,057.15 / $30,211.05
| Facility | | $12,487.65 | $18,057.15 | $30,211.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,660.04 / $20,578.00 / $26,741.00
| Facility | | $12,660.04 | $20,578.00 | $26,741.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $19,282.96 / $32,984.01
| Facility | | $5,274.00 | $19,282.96 | $32,984.01 |