- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,160.10 / $25,015.60 / $28,309.10
| Facility | | $16,160.10 | $25,015.60 | $28,309.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,274.47 / $23,102.20 / $31,201.26
| Facility | | $15,274.47 | $23,102.20 | $31,201.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,912.60 / $20,555.36 / $31,380.28
| Facility | | $14,912.60 | $20,555.36 | $31,380.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.00 / $20,738.00 / $29,981.00
| Facility | | $14,056.00 | $20,738.00 | $29,981.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,008.00 / $22,441.09 / $38,386.08
| Facility | | $4,008.00 | $22,441.09 | $38,386.08 |