- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,084.00 / $20,566.80 / $27,031.90
| Facility | | $14,084.00 | $20,566.80 | $27,031.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,400.63 / $11,984.57 / $20,270.28
| Facility | | $4,400.63 | $11,984.57 | $20,270.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,307.41 / $20,658.22 / $34,577.19
| Facility | | $14,307.41 | $20,658.22 | $34,577.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,715.75 / $23,054.84 / $33,661.94
| Facility | | $17,715.75 | $23,054.84 | $33,661.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,715.75 / $21,432.55 / $33,661.94
| Facility | | $17,715.75 | $21,432.55 | $33,661.94 |