- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,553.50 / $27,172.50 / $30,750.10
| Facility | | $17,553.50 | $27,172.50 | $30,750.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,276.09 / $27,666.65 / $38,024.64
| Facility | | $18,276.09 | $27,666.65 | $38,024.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,866.00 / $22,327.74 / $34,587.93
| Facility | | $15,866.00 | $22,327.74 | $34,587.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,370.47 / $21,624.00 / $32,566.00
| Facility | | $14,370.47 | $21,624.00 | $32,566.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $31,404.07 / $41,796.29
| Facility | | $5,274.00 | $31,404.07 | $41,796.29 |