- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,641.40 / $22,664.60 / $25,648.60
| Facility | | $14,641.40 | $22,664.60 | $25,648.60 |
- 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
- $13,511.09 / $18,623.54 / $28,431.11
| Facility | | $13,511.09 | $18,623.54 | $28,431.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.00 / $19,859.00 / $27,345.00
| Facility | | $14,056.00 | $19,859.00 | $27,345.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $26,194.09 / $34,862.22
| Facility | | $5,274.00 | $26,194.09 | $34,862.22 |