- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,523.90 / $22,482.70 / $25,442.70
| Facility | | $14,523.90 | $22,482.70 | $25,442.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,071.41 / $24,307.55 / $32,829.17
| Facility | | $16,071.41 | $24,307.55 | $32,829.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,402.65 / $18,474.06 / $28,618.18
| Facility | | $13,402.65 | $18,474.06 | $28,618.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,749.00 / $19,893.00 / $27,557.00
| Facility | | $13,749.00 | $19,893.00 | $27,557.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $25,983.85 / $34,582.41
| Facility | | $5,274.00 | $25,983.85 | $34,582.41 |