- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,589.30 / $24,132.00 / $27,309.20
| Facility | | $15,589.30 | $24,132.00 | $27,309.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,360.50 / $21,719.84 / $29,872.84
| Facility | | $14,360.50 | $21,719.84 | $29,872.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,395.62 / $22,213.97 / $33,482.00
| Facility | | $14,395.62 | $22,213.97 | $33,482.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,125.00 / $23,055.00 / $28,866.00
| Facility | | $15,125.00 | $23,055.00 | $28,866.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $28,098.97 / $37,119.39
| Facility | | $5,274.00 | $28,098.97 | $37,119.39 |