- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,602.20 / $25,711.80 / $30,070.00
| Facility | | $16,602.20 | $25,711.80 | $30,070.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,370.83 / $27,810.07 / $39,225.51
| Facility | | $18,370.83 | $27,810.07 | $39,225.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,330.94 / $23,870.87 / $34,480.00
| Facility | | $15,330.94 | $23,870.87 | $34,480.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,186.00 / $25,651.00 / $31,721.00
| Facility | | $16,186.00 | $25,651.00 | $31,721.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $29,702.12 / $39,531.12
| Facility | | $5,274.00 | $29,702.12 | $39,531.12 |