- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,176.40 / $23,492.70 / $26,585.70
| Facility | | $15,176.40 | $23,492.70 | $26,585.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,323.01 / $18,638.20 / $25,634.44
| Facility | | $12,323.01 | $18,638.20 | $25,634.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,014.26 / $20,920.00 / $33,018.60
| Facility | | $14,014.26 | $20,920.00 | $33,018.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,322.00 / $21,111.00 / $27,878.00
| Facility | | $14,322.00 | $21,111.00 | $27,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $27,151.19 / $36,136.04
| Facility | | $5,274.00 | $27,151.19 | $36,136.04 |