- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,398.00 / $21,025.30 / $27,634.50
| Facility | | $14,398.00 | $21,025.30 | $27,634.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,983.20 / $16,294.51 / $27,559.98
| Facility | | $5,983.20 | $16,294.51 | $27,559.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,626.38 / $21,118.77 / $35,348.05
| Facility | | $14,626.38 | $21,118.77 | $35,348.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,110.70 / $23,568.83 / $34,412.41
| Facility | | $18,110.70 | $23,568.83 | $34,412.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,110.70 / $21,910.37 / $34,412.41
| Facility | | $18,110.70 | $21,910.37 | $34,412.41 |