- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,395.20 / $28,488.50 / $32,224.40
| Facility | | $18,395.20 | $28,488.50 | $32,224.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,126.53 / $28,954.06 / $40,839.08
| Facility | | $19,126.53 | $28,954.06 | $40,839.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,986.61 / $26,448.81 / $36,246.31
| Facility | | $16,986.61 | $26,448.81 | $36,246.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,353.00 / $26,225.00 / $34,356.00
| Facility | | $18,353.00 | $26,225.00 | $34,356.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $25,544.83 / $43,695.11
| Facility | | $5,274.00 | $25,544.83 | $43,695.11 |