- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,625.10 / $21,091.50 / $23,868.30
| Facility | | $13,625.10 | $21,091.50 | $23,868.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,321.69 / $20,148.68 / $27,212.31
| Facility | | $13,321.69 | $20,148.68 | $27,212.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,581.83 / $17,330.91 / $26,457.75
| Facility | | $12,581.83 | $17,330.91 | $26,457.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,020.00 / $18,881.00 / $25,278.00
| Facility | | $13,020.00 | $18,881.00 | $25,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $24,376.00 / $32,442.49
| Facility | | $5,274.00 | $24,376.00 | $32,442.49 |