- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,691.70 / $22,742.50 / $25,736.80
| Facility | | $14,691.70 | $22,742.50 | $25,736.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,136.47 / $21,381.00 / $29,406.80
| Facility | | $14,136.47 | $21,381.00 | $29,406.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,566.75 / $20,934.93 / $31,964.25
| Facility | | $13,566.75 | $20,934.93 | $31,964.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,759.23 / $22,833.00 / $27,878.00
| Facility | | $14,759.23 | $22,833.00 | $27,878.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $26,284.19 / $34,982.14
| Facility | | $5,274.00 | $26,284.19 | $34,982.14 |