- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,769.00 / $25,958.00 / $29,375.70
| Facility | | $16,769.00 | $25,958.00 | $29,375.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,450.38 / $24,880.72 / $33,603.29
| Facility | | $16,450.38 | $24,880.72 | $33,603.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,474.44 / $21,806.26 / $33,042.01
| Facility | | $15,474.44 | $21,806.26 | $33,042.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,024.30 / $21,065.00 / $31,319.00
| Facility | | $15,024.30 | $21,065.00 | $31,319.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,008.00 / $21,497.96 / $39,832.31
| Facility | | $4,008.00 | $21,497.96 | $39,832.31 |