- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,526.70 / $24,046.10 / $27,422.00
| Facility | | $15,526.70 | $24,046.10 | $27,422.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,184.19 / $22,965.65 / $31,586.28
| Facility | | $15,184.19 | $22,965.65 | $31,586.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,328.03 / $22,124.66 / $33,482.00
| Facility | | $14,328.03 | $22,124.66 | $33,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,322.00 / $23,338.00 / $27,878.00
| Facility | | $14,322.00 | $23,338.00 | $27,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,217.00 / $14,152.00 / $36,855.01
| Facility | | $6,217.00 | $14,152.00 | $36,855.01 |