- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,517.20 / $25,568.20 / $28,934.50
| Facility | | $16,517.20 | $25,568.20 | $28,934.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,372.76 / $21,738.39 / $29,898.34
| Facility | | $14,372.76 | $21,738.39 | $29,898.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,242.06 / $23,536.06 / $33,482.00
| Facility | | $15,242.06 | $23,536.06 | $33,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,899.76 / $23,603.00 / $29,150.00
| Facility | | $14,899.76 | $23,603.00 | $29,150.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $29,549.94 / $39,328.58
| Facility | | $5,274.00 | $29,549.94 | $39,328.58 |