- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,648.60 / $21,127.80 / $23,909.50
| Facility | | $13,648.60 | $21,127.80 | $23,909.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,163.22 / $21,421.46 / $28,931.29
| Facility | | $14,163.22 | $21,421.46 | $28,931.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,603.53 / $17,360.80 / $26,503.39
| Facility | | $12,603.53 | $17,360.80 | $26,503.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,921.00 / $19,893.00 / $27,749.00
| Facility | | $12,921.00 | $19,893.00 | $27,749.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $24,600.97 / $32,498.46
| Facility | | $5,274.00 | $24,600.97 | $32,498.46 |