- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,614.40 / $29,219.30 / $39,210.00
| Facility | | $17,614.40 | $29,219.30 | $39,210.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,344.40 / $19,911.96 / $22,911.12
| Facility | | $16,344.40 | $19,911.96 | $22,911.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,796.15 / $25,602.27 / $40,964.62
| Facility | | $13,796.15 | $25,602.27 | $40,964.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,463.78 / $23,526.00 / $53,954.53
| Facility | | $14,463.78 | $23,526.00 | $53,954.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,172.41 / $23,174.68 / $32,829.75
| Facility | | $17,172.41 | $23,174.68 | $32,829.75 |