- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,756.70 / $25,939.00 / $29,354.10
| Facility | | $16,756.70 | $25,939.00 | $29,354.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,118.93 / $27,428.74 / $38,687.65
| Facility | | $18,118.93 | $27,428.74 | $38,687.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,473.56 / $24,092.94 / $34,480.00
| Facility | | $15,473.56 | $24,092.94 | $34,480.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,508.00 / $25,651.00 / $31,731.00
| Facility | | $17,508.00 | $25,651.00 | $31,731.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $30,203.02 / $39,898.87
| Facility | | $5,274.00 | $30,203.02 | $39,898.87 |